Orbital cellulitis or lymphoma? A diagnostic challenge

Salam, Aysha; Saldana, Manual; Zaman, Naeem

doi:10.1258/0022215054797880

Cited by 6 publications

(6 citation statements)

References 4 publications

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“…Additionally, other types of lymphoma such as T-cell, natural killer T-cell, and plasmablastic lymphoma presenting with orbital signs can be found in the literature. [9][10][11] The characteristic signs and symptoms of orbital cellulitis, which included proptosis, chemosis, eyelid swelling and erythema, decreased vision, and pain are very similar to those found with any orbital process. Thus, a high level of suspicion with a broad differential diagnosis is warranted.…”

Section: Discussionmentioning

confidence: 72%

A Unique Presentation of Diffuse Large B-Cell Lymphoma Involving the Central Nervous System

Lim

Patel

Aakalu

et al. 2013

Neuro-Ophthalmology

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Diffuse large B-cell lymphoma is the most common type of non-Hodgkin lymphoma, but ophthalmic presentations of this type of lymphoma constitute a small subset of these cases. An even smaller subset of cases involves the central nervous system at the time of presentation. The authors report a unique case of diffuse large B-cell lymphoma with central nervous system involvement initially presenting with ophthalmic manifestations and altered mental status.

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Section: Discussionmentioning

confidence: 72%

A Unique Presentation of Diffuse Large B-Cell Lymphoma Involving the Central Nervous System

Lim

Patel

Aakalu

et al. 2013

Neuro-Ophthalmology

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“…Only 4 (11.4%) were found to be positive for CD20. 50,54,62,76 Activation markers perforin (9/10, 90.0%), TIA-1 (28/29, 96.6%), and granzyme B (30/32, 93.8%) were positive in a majority of samples for which these markers were reported. Epstein-Barr encoded RNA (EBER) was positive in 58 Orbital NK/T-cell Lymphoma (93.5%) malignant tissue samples.…”

Section: Resultsmentioning

confidence: 98%

NK/T-cell Lymphoma With Orbital Involvement: A Case Report and Systematic Review of the Literature

Dhodapkar

Spadaro

Heng

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: To present the clinical course of a patient with recurrent NK/T-cell lymphoma (NKTL) involving the orbit and to review the literature on patients with NKTL involving the orbit. Methods: The PubMed database was searched for all cases of NKTL involving orbital, intraocular, or adnexal ocular structures. Results: Ninety-six patients were included in the final analysis. The mean age of diagnosis was 48.1 ± 16.8 years. The patients were 53/96 (55.2%) male and 43/96 (44.8%) female. Tumor location varied and included the orbit in 80/96 (83.3%), nasosinus in 56/96 (58.3%), uvea in 11/96 (11.5%), lacrimal gland in 9/96 (9.4%), lacrimal drainage system in 11/96 (11.5%), and conjunctiva in 7/96 (7.3%) cases. Management included surgical debulking in 29/96 (30.2%) cases, radiotherapy in 52/96 (54.2%) cases, and chemotherapy in 82/96 (85.4%) cases. Median survival was 6 months (95% CI: 5–9). Chemotherapy (hazard ratio = 0.80, 95% CI: 0.67–0.95, p = 0.013), radiotherapy (hazard ratio = 0.75, 95% CI: 0.64–0.87, p < 0.001), and orbital involvement being a recurrence of disease (hazard ratio = 0.79, 95% CI: 0.67–0.95, p = 0.009) were associated with improved survival. Advanced Ann Arbor stage (III–IV) at diagnosis (hazard ratio = 1.22, 95% CI: 1.08–1.38, p = 0.001), vision loss (hazard ratio = 1.18, 95% CI: 1.04–1.34, p = 0.009), proptosis (hazard ratio = 1.15, 95% CI: 1.01–1.30, p = 0.035) and periorbital swelling (hazard ratio = 1.15, 95% CI: 1.00–1.33, p = 0.048) were associated with poor survival. Conclusions: NK/T-cell lymphoma involving the orbit, globe, or ocular adnexa heralds a poor prognosis where early diagnosis and therapy are critical. The use of radiotherapy and chemotherapy is associated with improved survival.

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“…Lymphoma of orbit can masquerade as orbital cellulitis [14][15][16][17]. The pathophysiology behind orbital lymphoma presenting as orbital cellulitis can be due to direct tumor invasion responsible for inflammation of orbital soft tissues [17].…”

Section: Discussionmentioning

confidence: 99%

Orbital Lymphoma Masquerading as Orbital Cellulitis

Chaurasiya

Agrawal

Chaudhary

et al. 2021

Case Reports in Ophthalmological Medicine

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Background. Orbital lymphomas are primarily non-Hodgkin type and can originate from the eyelids, extraocular muscles, soft tissue orbital adnexa, conjunctiva, or lacrimal glands. Orbital malignancies often represent a diagnostic dilemma for clinicians given their varying and atypical presentations. Objective. To report a case of orbital lymphoma mimicking orbital cellulitis. Case. A 66-year-old male patient presented with sudden onset of painful proptosis with visual impairment in the left eye for 15 days. On ocular examination, best-corrected visual acuity was 6/12 in the right eye and 2/60 in the left eye, abaxial proptosis with hypertropia, swollen and erythematous eyelids, restricted extraocular movement in all cardinal position of gaze, conjunctival congestion with chemosis and tortuous vessels, sluggish pupillary reaction, and chorioretinal folds in the inferior quadrants. The case was diagnosed as left eye orbital cellulitis, and the patient was treated with broad-spectrum intravenous antibiotics and oral steroids. No clinically discernible response was noted despite 7 days of antibiotics and steroids. Contrast-enhanced computed tomography (CECT) orbit showed features suggestive of orbital lymphoma involving the ipsilateral maxillary and ethmoid sinuses. ENT consultation with diagnostic nasal endoscopy and biopsy was done. Histopathological reports showed features of non-Hodgkin lymphoma. Conclusion. Orbital malignancies masquerading as orbital cellulitis can pose a diagnostic dilemma. A multidisciplinary approach involving ENT consultation, radiological investigation, and pathological sampling can help achieve a timely diagnosis and appropriate management.

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Orbital cellulitis or lymphoma? A diagnostic challenge

Cited by 6 publications

References 4 publications

A Unique Presentation of Diffuse Large B-Cell Lymphoma Involving the Central Nervous System

A Unique Presentation of Diffuse Large B-Cell Lymphoma Involving the Central Nervous System

NK/T-cell Lymphoma With Orbital Involvement: A Case Report and Systematic Review of the Literature

Orbital Lymphoma Masquerading as Orbital Cellulitis

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