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Non-Hodgkin's orbital lymphoma.
S C Lutz1, S F Anderson, C Y Wu
1Primary Eye Care, Department of Veterans Affairs, VA Greater Los Angeles Healthcare System, Sepulveda Ambulatory Care Center and Nursing Home, Sepulveda, California, USA. msltz@msn.com
Summary
Orbital lymphoma, a manifestation of non-Hodgkin's lymphoma (NHL), can affect vision. External beam irradiation therapy is a standard treatment, but careful dosage is needed to avoid complications like radiation retinopathy.
Area of Science:
- Ophthalmology
- Oncology
- Hematology
Background:
- Non-Hodgkin's lymphoma (NHL) comprises malignant lymphocyte proliferation, with varied presentations based on disease site and aggressiveness.
- Ocular and orbital involvement can occur in patients with NHL, presenting diverse signs and symptoms.
Observation:
- A 47-year-old male with stage IV NHL experienced blurred vision and diplopia.
- Ocular examination revealed ptosis, proptosis, elevated intraocular pressure, and choroidal folds in the left eye.
- MRI confirmed orbital lymphoma, which resolved after 2400 rads of external beam irradiation therapy.
Findings:
- Orbital lymphoma is a potential complication of NHL, requiring prompt diagnosis and management.
- External beam irradiation therapy effectively treated the orbital lymphoma in this case.
- The patient later developed secondary radiation retinopathy, highlighting a potential treatment complication.
Implications:
- Orbital lymphoma requires consideration in NHL patients presenting with ocular symptoms.
- External beam irradiation is a primary treatment modality, but optimal dosing requires further investigation to balance efficacy and toxicity.
- Understanding treatment-related complications like radiation retinopathy is crucial for long-term patient care.