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Lymphoid lesions can cause proptosis in adults
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ATLANTA — Lymphoma is the most common orbital lymphoid tumor and accounts for about 50% of orbital proliferative lymphoid disorders, a physician said here.
"Orbital lymphoid lesions are the third most common cause of proptosis in adults," Robert H. Rosa Jr., MD, said at the American Academy of Ophthalmology meeting. Typical presentation is a slowly growing painless mass that molds to the globe and adjacent orbital structures.
"A painful, rapidly progressive orbital mass with signs of inflammation may be observed in diffuse large B-cell lymphoma," Dr. Rosa said.
Rare neuro-ophthalmic signs may be present that indicate intracranial involvement, and the presence or absence of systemic lymphoma at the time of presentation is often associated with the histological type, he said.
In the largest series to date studying 353 cases of ocular adnexal lymphoma, Dr. Rosa said the investigators found diffuse large B-cell disease in 7% of cases. The most common type was extranodal marginal zone lesions in 52% of cases.
"The location of the tumor, lid vs. orbit vs. conjunctiva, appears to correlate with the risk of disseminated disease. Eyelid lesions are associated with the greatest risk and conjunctival lesions with the lowest risk," Dr. Rosa said.