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Composite lymphoma of the orbit treated with rituximab
Shin J Kang1, Ingo Schmack, Ted H Wojno
1Emory Eye Center, Emory University of Medicine, Atlanta, GA 30322, USA.
Insights
This case study details an unusual orbital composite lymphoma, a rare dual diagnosis of follicular lymphoma and chronic lymphocytic leukemia/small lymphocytic lymphoma. Effective treatment with rituximab led to complete remission in an 82-year-old patient.
Area of Science:
- Hematology
- Oncology
- Ophthalmology
Background:
- Orbital masses can present with diverse etiologies, including lymphoid neoplasms.
- Composite lymphoma, a rare entity, involves the simultaneous occurrence of two distinct lymphoma types within a single tissue site.
Observation:
- An 82-year-old female presented with a right orbital mass.
- Histopathological examination revealed a dense lymphocytic infiltration with CD20-positive large lymphocytes.
- Flow cytometry identified two distinct cell populations.
Findings:
- The orbital biopsy confirmed a composite lymphoma, specifically a simultaneous follicular lymphoma (FL) and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL).
- Immunohistochemistry and flow cytometry were crucial in differentiating the two lymphoma subtypes.
Implications:
- This case highlights the importance of thorough diagnostic evaluation for orbital masses, especially in identifying rare composite lymphomas.
- Successful treatment with CD20 antibody (rituximab) demonstrates a viable therapeutic option for this rare condition.
- Further research into the pathogenesis and optimal management of orbital composite lymphomas is warranted.
Abstract:
We describe an unusual case of composite lymphoma (CL) in the orbit. The clinical history and biopsy specimen of an 82-year-old woman with a right orbital mass were evaluated. The orbital biopsy contained a dense lymphocytic infiltration and nodules of large lymphocyte that immunostained positive for CD20. Flow cytometric immunophenotyping showed two distinct populations of cells, confirming the diagnosis of a simultaneous follicular lymphoma (FL) and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). The patient was treated with CD20 antibody (rituximab) and is in remission at 3 months follow-up.