Presentation
Bilateral painless proptosis.
Patient Data
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An ill defined homogenous soft tissue intensity lesions are seen occupying the retro-orbital intra-conal spaces bilaterally. On the left side it occupies the superior portion of intra conal space and encases the optic nerve. On the right side it occupies the inferior portion of the space, encases and possibly infiltrates the inferior rectus and inferior oblique muscles. These lesions display low signal on T2, iso signal on T1 and avid enhancement on post contrast study.
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Follow up study 4 months later after the patient received three cycles of radiotherapy. There is time interval regressive course of both orbital lymphomatous infiltration and disappearance of the left side perineural spread.
Case Discussion
This patient has a known history of lymphoma.
Orbital lymphoma is a part from Non-Hodgkin lymphoma and associated with MALT lymphoma. Differential diagnosis includes orbital metastasis, rhabdomyosarcoma and pseudotumor.
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