[Primary non-Hodgkin orbital lymphoma: case report]

The aim of this case report is to present a very rare case of primary malignant non-Hodgkin orbital lymphoma, found in an 80-year-old female patient with rapid orbital structure compression. Detailed ophthalmologic, radiologic, hematologic and oncologic examinations and laboratory tests were done before, during and after treatment. Diagnostic ultrasonography and computed tomography images of the right orbital cavity demonstrated a solid naoplastic process which dislocated the eyeball without invasion of orbital structures. Upon diagnostic evaluation, tumor lesion was surgically removed including orbitotomy with lower transpalpebral approach. Histopathologic diagnosis and type of tumor tissue were defined by histology and immunohistochemistry analyses of open biopsy material obtained ex tempore. Finally, the diagnosis was confirmed by histopathology of the resected tumor mass: lymphoma malignum non-Hodgkin, diffuse large B-cell type, with high mitotic activity. Neoplastic B lymphocytes showed CD 20 positive surface antigens and kappa light chain expression. The treatment was continued with hematologic therapy. The patient received three cycles of systemic chemotherapy (CHOP protocol). Upon combined therapy completion, control examinations showed the patient to have no signs of disease in the orbital region. Interdisciplinary approach in the diagnostic evaluation, therapy and long-term observation proved to be necessary in patients with malignant non-Hodgkin lymphoma.