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Uniformly Sclerotic Diffuse Large B-Cell Lymphoma of the Orbit
Frederick A Jakobiec1, Anna M Stagner, Daniel R Lefebvre
1*David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts; †Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; and ‡Ophthalmic Plastic Surgery Service, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts, U.S.A.
Abstract:
Over a year, a 51-year-old man developed a mass in the anteromedial orbit in the region of the lacrimal sac that caused epiphora. Imaging studies disclosed no bone destruction. On biopsy, a sclerotic lesion was discovered populated by hyperchromatic cells that had been apparently distorted by crush artifact, indicative of fragile cells. The lesion simulated a sclerosing inflammatory process or a desmoplastic metastatic carcinoma. CD20 revealed that the background cells were large neoplastic B-lymphocytes. A systemic workup uncovered widespread skeletal disease. The patient is undergoing R-CHOP chemotherapy with a relatively favorable prognosis due to negative testing for MYC.
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