Abstract
A 73-year-old woman presented with a rapidly growing bilateral orbital swelling, causing diplopia and epiphora. During physical examination, there were exophthalmos and orbital edema, both more prominent in the right eye (Figures 1A and 1B). The conjunctiva of both eyes was swollen. The lesions extended to the right iris and partially covered the left one. computed tomography revealed, in both eyes, a mass (right eye: 2.7 cm × 2.14 cm; left eye: 1.88 cm × 1 cm) involving the lacrimal gland and adjacent to the superior rectus and lateral rectus muscles. Histological and immunohistochemical analyses showed a population of small atypical lymphocytes, with slightly irregular indented nuclei and moderately dispersed chromatin. Malignant cells were CD19+, CD20+, CD5+, CD23−, CD10−, and hyperexpression of cyclin D1 was detected.
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