Faculty Collaboration Database

Necrobiotic Xanthogranuloma With Associated Monoclonal Gammopathy Presenting as an Eyelid Nodule. Ophthalmic Plast Reconstr Surg 2023 Sep-Oct 01;39(5):e148-e150

Date

06/06/2023

Pubmed ID

37279015

DOI

10.1097/IOP.0000000000002399

Scopus ID

2-s2.0-85170294839 (requires institutional sign-in at Scopus site)

Abstract

Necrobiotic xanthogranuloma (NXG) is a progressive non-Langerhans cell histiocytosis with a predilection for the periorbital area. NXG is most commonly associated with monoclonal gammopathy and ophthalmic complications. The authors present a 69-year-old man who was evaluated for a left upper eyelid nodule and plaques on the lower extremities, trunk, abdomen, and right upper extremity. Biopsy of the eyelid was supportive for NXG. Serum protein electrophoresis was positive for a monoclonal gammopathy, IgG light chain kappa. MRI showed preseptal involvement. The periocular nodules cleared with a high dose of prednisone; however, the other skin lesions persisted. Bone marrow biopsy showed kappa-restricted 6% plasma cells and he was treated with intravenous immunoglobulin. This case illustrates the importance of clinicopathologic correlations to render an NXG diagnosis.

Author List

Punyamurthy NT, Tjahjono LA, Harris GJ, Wanat KA

Authors

Gerald J. Harris MD Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin
Karolyn A. Wanat MD Vice Chair, Professor in the Dermatology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Eyelids
Face
Humans
Male
Necrobiotic Xanthogranuloma
Paraproteinemias
Plasma Cells