Orbital lymphoproliferative lesions

Orbital lymphoproliferative lesions compromise a wide spectrum of diseases ranging from benign to malignant.

Patient's may present with a palpable mass or proptosis. Pain is an uncommon symptom unlike orbital pseudotumour, which manifests with acute pain.

These lesions represent a spectrum of disorders, including:

  • lymphoid hyperplasia of the orbit (benign) 10-40% 1
  • atypical lymphoid hyperplasia of the orbit 
  • ocular adnexal lymphoma (NHL) (malignant) most common 60-90% 1

Lesions may be a manifestation of systemic lymphoma or arise primarily from the orbit.

Major long-term risk is development of systemic lymphoma (33-50%) in 10 years after the initial diagnosis of orbital lymphoproliferative disorder. 1

General
  • may be seen as a solid, homogeneously enhancing orbital tumour that moulds to and encases orbital structures
  • It can occur anywhere in the orbit with predilection for anterior extraconal space (often in the superotemporal quadrant) and lacrimal gland (in 40% of cases) 2
  • bilateral in 25% of patients 1
CT
  • iso-attennuating to slightly hyperattenuating (highly cellular).
  • diffuse homogeneous post contrast enhancement
  • bone destruction indicates aggressive histology
MRI

Modality of choice for evaluating location and extent of disease.1

  • T1: mildly hyperintsee to muscle; homogenous
  • T2: mildly hyperinense to muscle
  • T1 WI C+: moderate to marked homogenous enhancement

On imaging, possible considerations include

 

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Article Information

rID: 46838
System: Head & Neck
Section: Pathology
Tag: cases
Synonyms or Alternate Spellings:
  • Ocular adnexal lymphoma (OAL)
  • Orbital lymphoprolifertaive tumors (OLT)
  • Orbital lymphoprolifertaive tumours (OLT)
  • Orbital lymphoprolifertaive tumors
  • Orbital lymphoprolifertaive tumours

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