UNUSUAL PRESENTATION OF LACRIMAL GLAND LYMPHOMA - A CASE REPORT

Abstract

Lymphomas of the eye and its adnexa account for approximately 10 of all extranodal malignant lymphomas 2. The most common primary lymphoma subtype occurring in the ocular adnexa is the low-grade malignant extranodal  marginal zone B-cell lymphoma of MALT type  (mucosa-associated lymphoid tissue) 3. A 43-year old female reported to the eye department with complaints of swelling in the left upper lid for past 2 years duration, which was painless, gradually increasing in size. Her left eye examination showed a firm, non tender mass of palpable in superolateral aspect of orbit, not pulsatile and not reducible. Computed tomography of the orbit scan showed a mass in the left lacrimal fossa with calcification Figure1. Provisional diagnosis of pleomorphic adenoma of lacrimal gland was made. Lateral orbitotomy and excision biopsy of mass was done. Histopathology report showed atypical lymphoid  infiltrate suspicious of low grade B-cell non-Hodgkins            lymphoma with concomitant amyloid deposits of the left          lacrimal gland. Post operatively radiotherapy was given and there was no residual tumour noted in imaging. Role of  surgery is limited to biopsy only. Long term follow up is needed in these patients, once in six months for first five years and annually therefore, as recurrence is a possibility.