Orbital lymphoma in a patient with Felty's syndrome

A 72-year-old woman presented with a diffuse infiltrating soft tissue mass involving the entire right orbit. She had a pre-existing phthisis of the right eye secondary to retinal detachment, and had developed painless proptosis on the same side. Her medical history included rheumatoid arthritis, leucopenia, and an enlarged spleen, characteristics consistent with the diagnosis of Felty's syndrome. Risk of lymphoma is thought to be higher in patients with established connective tissue disorders. The case described herein, to our knowledge, represents the first report of an association between Felty's syndrome and orbital lymphoma. The symptoms of Felty's syndrome in our patient were initially attributed to spread of a malignant process involving the orbit.