title: Characteristics of orbital lymphoma: a clinicopathological study of 26 cases.
abstract: OBJECTIVE
  Evaluation of the medical data of patients with orbital and adnexal lymphoma.
  
  
  METHODS
  Cohort study of all cases diagnosed with orbital or adnexal lymphoma at Meir Medical Center between 1993 and 2007.
  
  
  METHODS
  Twenty-six patients, with intraorbital or subconjunctival masses with orbital involvement, were examined and followed up between 1 and 8 years.
  
  
  METHODS
  Examined data included: clinical presentation, age, gender, imaging, tumor location, surgical management, and pathological diagnosis.
  
  
  RESULTS
  Presenting signs and symptoms included proptosis, eyelid lesions, tearing, chemosis, decreased visual acuity, ptosis, pain, squint, and optic nerve compression. In five cases, lymphoma was misdiagnosed on neuroimaging. Bone changes were seen in four patients. All cases were B cell lymphomas; with the majority (22 cases) of small B cell type; consisting of primary extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue and two cases of small cell lymphoma. One small cell lymphomas was of follicular type on a background of CLL, and the other was CLL/SLL type. Fourteen cases were primary orbital disease, and 12 cases were systemic disease. Macroscopic appearance of lymphoma at open biopsy was characteristic in most cases. Flow cytometry phenotyping gave rapid reliable diagnosis of the disease.
  
  
  CONCLUSIONS
  Epiphora or chemosis in the presence of an orbital mass should alert the ophthalmologist to suspect lymphoma. Lymphoma may be easily misinterpreted on neuroimaging for other diseases. Bone changes seen on CT are more common than is generally perceived. Macroscopic appearance at open biopsy was characteristic.
authors.affiliation: Department of Ophthalmology, Technion Faculty of Medicine, Emek Medical Center, Afula, Israel. briscoe@013.net.|Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel. briscoe@013.net.
authors.forename: Daniel
authors.initials: D
authors.lastname: Briscoe
authors.affiliation: Department of Ophthalmology, Technion Faculty of Medicine, Emek Medical Center, Afula, Israel.|Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel.
authors.forename: Christine
authors.initials: C
authors.lastname: Safieh
authors.affiliation: Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel.
authors.forename: Yokrat
authors.initials: Y
authors.lastname: Ton
authors.affiliation: Department of Haematocytology, Meir Medical Center, Kfar Saba, Israel.
authors.forename: Hava
authors.initials: H
authors.lastname: Shapiro
authors.affiliation: Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel.
authors.forename: Ehud I
authors.initials: EI
authors.lastname: Assia
authors.affiliation: Department of Pathology, Meir Medical Center, Kfar Saba, Israel.
authors.forename: Dvora
authors.initials: D
authors.lastname: Kidron
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009918:Orbital Neoplasms / Q000175:diagnosis* / Q000628:therapy; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Adnexal lymphoma; B cell lymphoma; Chemosis; Epiphora; Mucosa-associated lymphoid tissue; Orbital lymphoma