Orbital reactive lymphoid hyperplasia: Case series and literature review

This study aimed to describe a case series of patients diagnosed with orbital reactive lymphoid hyperplasia (RLH) at a single tertiary care centre. A retrospective review was conducted by searching electronic medical records at Liverpool University NHS Foundation Trust (LUHFT) from 1^st December 2021 - 1^st December 2023, to identify all patients with a histological diagnosis. Ten patients with an orbital histological diagnosis of RLH were identified. Median age at diagnosis was 56.5 years. Proptosis was the most prevalent presenting symptom, while other signs included palpable mass, ptosis, and diplopia. Eight patients were treated with oral prednisolone, with 20% (two) achieving complete remission. Additional treatments utilised in these cases encompassed doxycycline, mycophenolate, ciclosporin, and azathioprine.This case series represents one of the few reports focusing exclusively on orbital RLH. Notably, bone erosion was observed in this study, a finding that has been scarcely linked to RLH in the literature.