Bilateral Exophtalmy, Revealing a Lymphoma not Hodgkinien of the Coat Type

Abstract

Introduction: The Non hodgkinien lymphma (NHL) orbital location is a rare tumor, difficult to diagnose. The mantle cell lymphoma represents 6% of cases of LNH B. We report a patient of 60 years with bilateral exophthalmia revealing a mantle cell lymphoma. Clinical Observation: A man of 60 years ran for ophthalmological emergencies in an array of orbital cellulitis of the right eye. This swelling was that day, painful, inflammatory, axile, irreducible, and non-pulsatile, with limited horizontal movement of the eyeball. In general terms, the patient has axillary lymph nodes and supraclavicular without splenomegaly. A biopsy of the orbital mass produced by trans-conjunctival, concluded in a non-Hodgkin lymphoma B type mantle (CD20 +, CD5 +, cyclin D1 +). The assessment of extension realized in the Hematology Clinic department shows that this is a mantle cell lymphoma NHL B stage (nodes above and below the diaphragm, bilateral eyelid damage, spinal cord and location). After 3 treatments Rituximab-CHOP and DHAP-Rituximab treatments 3, obtaining a complete remission. Discussion: The mantle cell lymphoma represents about 6% of NHL. Its incidence is estimated between 0.07 and three cases per 100 000 population per year. The geographical area and ethnicity shows a higher frequency in Caucasians than in African Americans. Ocular involvement in the NHL is a rare event, as evidenced by the limited number of cases reported in the literature. It may be opening that is the case of our patient, or alter the course of lymphoma known. Conclusion: The eye location of mantle cell lymphoma is a rare entity. The clinical picture of this location can be misleading, particularly that of orbital cellulitis. The tumor biopsy confirms the diagnosis. Despite the treatment regimens, the prognosis of this type of lymphoma is reserved.