case_images: PMC7758142_01
case_images: Reduction of swelling and erythema was noted around the right paranasal sinuses and right eye after nasal washout.
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case_images: fig1
case_images: Postoperatively, the patient felt better and the swelling and erythema around the right eye markedly decreased (see Figure 1).
case_images: Exuberant periorbital edema, erythema, and superficial excoriation with serous drainage were noted over the right eye and right paranasal region.
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case_images: PMC7758142_01_CRIM2020-6646693.002.jpg
case_images: fig2
case_images: However, the patient continued to have worsening right periorbital edema, erythema, and chemosis despite on appropriate antibiotic therapy (see Figure 2).
case_images: There were dense atypical lymphoid cells with irregular nucleoli (H&E stain, 400X).
case_images: CRIM2020-6646693.003.jpg
case_images: PMC7758142_01_CRIM2020-6646693.003.jpg
case_images: fig3
case_images: T cells with irregular nucleoli (see Figure 3), which were positive for natural killer cells or cytotoxic T-cell markers:CD2, CD3, and CD56 on the immunohistochemistry study. The neoplastic cells were negative for CD4, CD8, and CD7 on immunophenotype evaluation.
case_images: In situ hybridization was diffusely positive for Epstein-Barr virus (EBV) RNA.
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case_images: fig4
case_images: In situ hybridization was strongly positive for Epstein-Barr virus (EBV) RNA (see Figure 4).
case_images: Significant resolution of the right periorbital edema and erythema was noted after 3 cycles of chemotherapy. The right eye was eventually able to fully open.
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case_images: PMC7758142_01_CRIM2020-6646693.005.jpg
case_images: fig5
case_images: The right periorbital edema and erythema had almost resolved (see Figure 5).