Multiple ocular impairment in a patient affected by Waldenstrom's macroglobulinaemia

Background: We studied a bilateral tumefaction of the lacrimal gland in a female patient. Method: Ocular and general clinical examinations were carried out. Result: Computerized tomography (CT) of the cranial orbit showed a tumefaction of solid density in the lacrimal gland. Histological examination of material removed by needle aspiration revealed the presence of elements of a lymphoplasmacytoid nature. Fluorescein angiography showed dilatation of the veins, intraretinal flame haemorrhages and small ischaemic areas. Chest CT showed an increase in the size of the middle and upper mediastinal lymph nodes, and examination of a specimen of bone marrow from the chest revealed the presence of small lymphocytes with a plasmacytoid tendency. Conclusion: On the basis of the findings, we diagnosed Waldenstrom's disease with rare multiple ocular impairment (lacrimal gland and retina) in an early stage.