title: Incidental diagnosis of orbital lymphoma during blepharoplasty.
abstract: OBJECTIVE
  To describe the incidental diagnosis of orbital lymphoma in 3 patients, in whom unusual findings at the time of blepharoplasty led to the diagnosis of orbital lymphoma.
  
  
  METHODS
  A retrospective review of the medical records of 3 patients.
  
  
  RESULTS
  Two patients presented with bilateral dermatochalasis that obscured the upper visual field and was more prominent on one side. One patient presented with bilateral ptosis and dermatochalasis. All three patients underwent bilateral upper blepharoplasty. In one patient, bilateral ptosis repair was performed in addition to upper blepharoplasty. Blepharoplasty specimens were sent for histopathologic analysis because of the unusual appearance of the preaponeurotic fat at the time of surgery. Histopathology showed low-grade B-cell lymphocytic lymphoma in all three cases. Postoperative CT scan showed a mass in the lacrimal fossa in one patient. None of the patients had evidence of systemic involvement. Two patients were treated with external beam radiotherapy with good results. One patient recently diagnosed with orbital lymphoma was referred to the oncology clinic for further treatment.
  
  
  CONCLUSIONS
  Histopathologic evaluation of blepharoplasty specimens is highly recommended in cases in which the orbital fat has an unusual appearance, color, or consistency at the time of surgery.
authors.affiliation: Baylor College of Medicine, Department of Opthalmology, Houston, Texas, USA.
authors.forename: Yonca Ozkan
authors.initials: YO
authors.lastname: Arat
authors.forename: Milton
authors.initials: M
authors.lastname: Boniuk
mesh_terms: D000368:Aged; D019882:Blepharoplasty; D001763:Blepharoptosis / Q000601:surgery; D003483:Cutis Laxa / Q000601:surgery; D005260:Female; D006801:Humans; D033162:Incidental Findings; D007432:Intraoperative Period; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009918:Orbital Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000532:radiotherapy; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed