Presentation
Proptosis.
Patient Data
Right-sided proptosis due to infiltrative soft tissue involving the intra- and extraconal spaces of the right superior and mid-orbit, with extraocular muscle involvement, most extensive in the superior rectus. This infiltrative soft tissue encases the optic nerve.
Multifocal transspatial infiltrative mass of the bilateral orbits (right greater than left) involving the extraocular muscles with extension into the extra/intraconal fat, as well as the infraorbital nerve on the right. The right optic nerve is encased.
Metabolically active soft tissue with fusiform configuration in the anterior mediastinum and left posterior pleura.
Left upper/posteromedial nodular pleural thickening, fusiform anterior mediastinal mass. No pleural effusion, lungs clear.
Case Discussion
The right orbital contents were sent for pathologic evaluation and a diagnosis of lymphoma was made. Lymphoma can present as an intraorbital mass and should be in the differential diagnosis for pleural thickening.
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