title: Periorbital non-Hodgkin's lymphoma after blunt trauma.
abstract: The head and neck region is the second most common site for the development of extranodal lymphomas. Richter's syndrome (RS) involves the transformation of B-cell chronic lymphocytic leukemia (B-CLL) to an aggressive lymphoma, most commonly, diffuse large B-cell lymphoma (DLBCL). We report the case of a 62-year-old man who developed DLBCL in the periorbital region 2 months after blunt trauma to the site. The patient lacked other physical symptoms at the time of presentation. Bone marrow biopsy and immunophenotypic analysis revealed a Richter transformation of unknown B-CLL. RS frequently arises in lymph nodes or bone marrow and rarely presents with extranodal involvement. Chemotherapy resulted in total remission of the lymphoma and no relapse was observed in the 6-month follow-up period. This case demonstrates that the clinician must recognize that unresolved soft tissue swelling after a trauma may be caused by NHL.
authors.affiliation: Department of Oral and Plastic Maxillofacial Surgery, Ruhr-University Bochum, Knappschaftskrankenhaus Bochum-Langendreer, Germany. marcus.kriwalsky@ruhr-uni-bochum.de
authors.forename: Marcus Stephan
authors.initials: MS
authors.lastname: Kriwalsky
authors.forename: Roland
authors.initials: R
authors.lastname: Schroers
authors.forename: Ingo
authors.initials: I
authors.lastname: Stricker
authors.forename: Stefan
authors.initials: S
authors.lastname: Hollstein
authors.forename: Martin
authors.initials: M
authors.lastname: Kunkel
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D003520:Cyclophosphamide; D004317:Doxorubicin; D005151:Facial Injuries / Q000473:pathology*; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000473:pathology*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000293:injuries; D011241:Prednisone; D000069283:Rituximab; D016896:Treatment Outcome; D014750:Vincristine
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone