Orbital lymphoid lesions: short series with cytohistological correlation

  • Neelam Sood Deen Dayal Upadhyay Hospital , new delhi
  • Priyanka Bhatia Soni Deen Dayal Upadhyay Hospital , New Delhi , India
Keywords: Orbital lymphoid hyperplasia, Pseudolymphoma, lymphoma.

Abstract

Orbit and ocular adnexae are common sites (10-15%) for developing lymphoid lesions but have diagnostic and staging difficulties similar to other extranodal sites. Out of 15 fine needle aspirates from orbital lesions received in last 5 years three female patients of age 56, 46 and 72 years  presented to FNAC clinic with upper eyelid swellings of  2 years, 3 years and 3 months  duration. Systemic examination was unremarkable. Hematological and Serum protein electrophoresis was normal. On MRI case 1 was suggestive of infective/neoplastic lesion. On CECT case 2 was suggestive of pseudotumor/lymphoma while case 3 was suggestive of pseudotumor. FNAC of case 1 showed polymorphous population of lymphoid cells, without any significant mitosis. FNAC of  case 2  showed a monotonous  population  of lymphoid cells and Case 3 showed a  relatively monotonous  population in a background of lymphoglandular bodies. Case 1: Responded to steroids. Case 2:  was  advised  a  biopsy  for  confirmation,  Case 3: Excision done in view of the recurrent nature with no response to steroids. Histopathology in Case 2 showed  a  non encapsulated  mass  with  proliferation   of  lymphoid  cells forming  nodules, IHC showed  a  monoclonal  pattern while Case 3 showed a nonencapsulated mass with nodular proliferation of  lymphoid cells involving the surrounding adipose tissue with formation of primary and secondary follicles and Immunohistochemistry (IHC) showed a polyclonal population. Three cases are being discussed to highlight the diagnostic dilemmas in orbital lymphoid lesions and relevance of IHC in such cases.

Author Biographies

Neelam Sood, Deen Dayal Upadhyay Hospital , new delhi
Head of department , Pathology
Priyanka Bhatia Soni, Deen Dayal Upadhyay Hospital , New Delhi , India
Senior Resident Pathology

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Published
2016-05-08
Section
Case Report