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A Rare Presentation

Bita Esmaeli, MD; L. Jeffrey Medeiros, MD; Jeffrey Myers, MD; Richard Champlin, MD; Sanjay Singh, MD; Lawrence Ginsberg, MD

Arch Ophthalmol. 2001;119:443-446.

We describe a 40-year-old woman with a history of precursor T-cell acute lymphoblastic leukemia who developed an orbital mass associated with diffuse infiltration of the paranasal sinuses. The clinical and radiologic findings suggested an orbital abscess. Examination of orbital and ethmoid sinus biopsy specimens revealed relapse of precursor T-cell acute lymphoblastic leukemia. Although orbital involvement by granulocytic sarcoma (also known as extramedullary myeloid cell tumor and chloroma) with or without concurrent acute myeloid leukemia is well described in the literature, similar presence of acute lymphoblastic leukemia of either precursor T-cell or B-cell lineage is rare.

From the Department of Plastic Surgery, Ophthalmology Section (Dr Esmaeli), and the Departments of Hematopathology (Dr Medeiros), Head and Neck Surgery (Dr Myers), Bone Marrow Transplantation (Dr Champlin), and Radiology (Drs Singh and Ginsberg), M. D. Anderson Cancer Center, Houston, Tex.