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Incidental diagnosis of orbital lymphoma during blepharoplasty
Yonca Ozkan Arat1, Milton Boniuk
1Baylor College of Medicine, Department of Opthalmology, Houston, Texas, USA.
Purpose:
To describe the incidental diagnosis of orbital lymphoma in 3 patients, in whom unusual findings at the time of blepharoplasty led to the diagnosis of orbital lymphoma.
Methods:
A retrospective review of the medical records of 3 patients.
Results:
Two patients presented with bilateral dermatochalasis that obscured the upper visual field and was more prominent on one side. One patient presented with bilateral ptosis and dermatochalasis. All three patients underwent bilateral upper blepharoplasty. In one patient, bilateral ptosis repair was performed in addition to upper blepharoplasty. Blepharoplasty specimens were sent for histopathologic analysis because of the unusual appearance of the preaponeurotic fat at the time of surgery. Histopathology showed low-grade B-cell lymphocytic lymphoma in all three cases. Postoperative CT scan showed a mass in the lacrimal fossa in one patient. None of the patients had evidence of systemic involvement. Two patients were treated with external beam radiotherapy with good results. One patient recently diagnosed with orbital lymphoma was referred to the oncology clinic for further treatment.
Conclusions:
Histopathologic evaluation of blepharoplasty specimens is highly recommended in cases in which the orbital fat has an unusual appearance, color, or consistency at the time of surgery.