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Orbital Lymphoma Masquerading as Orbital Cellulitis.

B D Chaurasiya1, Ganesh Agrawal2, Santosh Chaudhary3

  • 1Department of Ophthalmology, Narayani Hospital, Birgunj, Nepal.

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|September 20, 2021
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Summary

Orbital lymphoma can mimic orbital cellulitis, presenting a diagnostic challenge. Early diagnosis requires a multidisciplinary approach including imaging and biopsy for effective management of this rare orbital malignancy.

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Area of Science:

  • Ophthalmology
  • Oncology
  • Pathology

Background:

  • Orbital lymphomas, predominantly non-Hodgkin type, can arise from various orbital structures.
  • Orbital malignancies frequently present atypically, posing diagnostic challenges for clinicians.

Observation:

  • A 66-year-old male presented with acute painful proptosis and visual loss in the left eye.
  • Initial symptoms included proptosis, eyelid swelling, restricted eye movements, and conjunctival congestion, mimicking orbital cellulitis.
  • Despite treatment with antibiotics and steroids, the patient showed no improvement.

Findings:

  • Contrast-enhanced computed tomography (CECT) revealed orbital lymphoma involving maxillary and ethmoid sinuses.
  • Histopathological examination confirmed non-Hodgkin lymphoma.

Implications:

  • Orbital malignancies can masquerade as common orbital infections like cellulitis.
  • A multidisciplinary approach combining ENT consultation, radiological imaging (CECT), and histopathological biopsy is crucial for accurate diagnosis and timely management of orbital lymphoma.