A 69-year-old Japanese male presented with a 3-month history of bilateral ptosis with lacrimal gland bulge. He came from western Japan, an area endemic for human T-lymphotropic virus Type 1 infection. Physical examination and imaging revealed bilaterally enlarged lacrimal glands. Hematologic testing, biopsy with histopathology, and immunohistochemistry were all consistent with adult T-cell leukemia/lymphoma. (C) 2017 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.
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