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Case Report
Primary diffuse large B-cell lymphoma of the orbit: Case report
1 Resident, Department of Anatomopathology, Ibn Rochd University Hospital Center, Hassan II University of Casablanca, Faculty of Medicine and Pharmacy, Casablanca, Morocco
2 Resident, Department of Stomatology Oral and Maxillofacial Surgery, 20 August 1953, Hassan II University of Casablanca, Faculty of Medicine and Pharmacy, Casablanca, Morocco
3 Professor, Department of Anatomopathology, Ibn Rochd University Hospital Center, Hassan II University of Casablanca, Faculty of Medicine and Pharmacy, Casablanca, Morocco
4 Professor, Department of Stomatology Oral and Maxillofacial Surgery, 20 August 1953, Hassan II University of Casablanca, Faculty of Medicine and Pharmacy, Casablanca, Morocco
5 Professor and Chief of Anatomopathology Department, Ibn Rochd University Hospital Center, Hassan II University of Casablanca, Faculty of Medicine and Pharmacy, Casablanca, Morocco
Address correspondence to:
Siham Nagib
Casablanca, Morocco,
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Article ID: 100012P03SN2024
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Nagib S, Abatourab M, Nihad DSF, Opoko U, Benayad S, Slimani F, Karkouri M. Primary diffuse large B-cell lymphoma of the orbit: Case report. Edorium J Pathol 2024;8(1):1–7ABSTRACT
Introduction: Ocular adnexal lymphoma is a rare disease, the diagnosis may masquerade as orbital inflammatory disease, which can be challenging for both of pathologist and ophthalmologist. Therefore, it can progress rapidly to complete visual loss if the diagnosis was made tardily.
Case report: We report a case of primary diffuse large B-cell lymphoma (DLBCL) of the orbit in a 66-year-old man without history of lymphoma, who presented progressive decrease of visual acuity of his left eye, for three months. The clinical examination showed ptosis of the left eye, exophthalmos, swelling, and diplopia without sensory-motor disorder. Magnetic resonance imaging showed an intraconal soft tissue mass, poorly limited infiltrating superior and inferior rectus muscles and around the optic nerve without invading it, nor bone structures. Inflammatory pseudotumor was suggested. Histopathologic evaluation of incisional biopsy revealed infiltration of orbital soft tissue by sheets of dyscohesive, round and large lymphomatoid cells in a diffuse pattern. The tumoral lymphomatoid cells showed expression of CD20, Bcl2, Bcl6, CD10, and MUM1. The Ki-67 proliferation index was estimated at 80%, and they were negative for CD3 and CD5. On the basis of histological results and the absence of other tumor localization, the diagnosis of primary diffuse large B-cell lymphoma of orbit was retained. The patient was referred to the hematologist-oncologist. He underwent a positron emission tomography-computed tomography (PET/CT) scan, which showed no other localization, and he received chemotherapy with a complete remission and a good tolerance to the treatment.
Conclusion: Diffuse large B-cell lymphoma (DLBCL) is the second-most common non-Hodgkin’s lymphoma (NHL) in orbit, affected usually elderly patients (average age 69), with no sex predilection. It can manifest as exophthalmos, pain, decreased visual acuity, diplopia, and ptosis, and it has often a poor prognosis.
Keywords: Diffuse large B-cell lymphoma, Histology, Ocular adnexal lymphoma, Primary orbital lymphoma
SUPPORTING INFORMATION
Author Contributions:
Siham Nagib - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Manal Abatourab - Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Da Silva Fidélia Nihad - Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Ulrich Opoko - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Samira Benayad - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Faiçal Slimani - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Mehdi Karkouri - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Siham Nagib et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
