76-year-old man presented with left-sided proptosis

Images

Doctor's Information

Name : Morteza
Family : Sanei Taheri
Affiliation :Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree : Associate Professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Sima Salimi,Afarin Sadeghian

Case Section

Head & Neck Imaging

Patient's Information

Gender : Male
Age : 76

Clinical Summary

76-year-old man presented with left-sided proptosis

Imaging Findings

MR images demostrate infiltrating orbital lesions with intra- and extra-conal involvement in superior aspect of both orbits along medial and inferior extension as well as preseptal involvement,bilaterally.The mentioned lesions appear isointense compared with the brain parenchyma and show homogeneous contrast enhancement ,similar to that of the extraocular muscles.

Differential Diagnosis

1.Inflammatory pseudotumor,2.Primary orbital lymphoma,3.Metastasis,4.Lacrimal gland tumors

Final Diagnosis

Orbital Lymphoma

Discussion (Related Text)

Orbital lymphomas account for only 2% of all lymphomas, but constitute 5 - 15% of all extranodal lymphomas and approximately 50% of all primary orbital malignancies in adults.Recently an association between Chlamydia psittaci infection and orbital adnexal MALT lymphoma has been described (MALT-lymphomas account for the majority of orbital lymphomas). Infection by Chlamydia psittaci is usually the result of exposure to infected birds and household pets. Patients may go on to develop psittacosis, usually with respiratory tract manifestations.This possible infective aetiology may explain the probably increase in incidence of orbital lymphomas.Typically patients are between 50 and 70 years of age, and no gender predilection is recognised.

References

Harnsberger,”Diagnostic Imaging of head and neck”,pp.II-1-66,Dr Ruberto Schubert,Dr Frank Gaillard”Orbital Lymphoma”