Orbital Lymphoma Research Articles

Secondary orbital lymphoma

Case reportA case is presented of an 85-year-old Caucasian female with lymphoma that recurred in the orbit (secondary ocular adnexal lymphoma). The orbital tumour was a diffuse large B-cell lymphoma according to the REAL classification (Revised European-American Lymphoma Classification). DiscussionOrbital lymphomas are predominantly B-cell proliferations of a variety of histological types, and most are low-grade tumours. Patients are usually middle-aged or elderly, and it is slightly more common in women. A palpable mass, proptosis and blepharoptosis are the most common signs of presentation.

Genome-Wide Analysis of Ocular Adnexal Lymphoproliferative Disorders Using High-Resolution Single Nucleotide Polymorphism Array.

We identified the genomic signature of ocular adnexal lymphoproliferative disorders (LPDs), especially ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma, IgG4-related ophthalmic disease (IgG4-ROD), reactive lymphoid hyperplasia (RLH), and diffuse large B-cell lymphoma (DLBCL). We included 52 subjects with ocular adnexal LPDs (13 orbital MALT lymphomas, 16 conjunctival MALT lymphomas, 13 IgG4-RODs, 4 RLHs, and 6 DLBCLs) who had been treated at the Tokyo Medical University Hospital from 2008 to 2012. Genomic DNA was extracted from the tumor tissues and subjected to high-resolution single nucleotide polymorphism array (SNP-A) karyotyping using GeneChip Human Mapping 250K SNP arrays. The array data were investigated using Copy Number Analysis for GeneChips (CNAG) software. In ocular adnexal MALT lymphomas, the most frequent copy number (CN) gain region was trisomy 3 detected in 31% (9/29), followed by trisomy 18 in 17% (5/29), and 6p and 21q in 14% (4/29). The most frequent CN loss regions were 6q and 9p, detected in 7% (2/29). Uniparental disomy was detected on 6q in 14% (4/29), followed by 3q in 10% (3/29). Copy number variations (CNVs) were not detected in IgG4-RODs and RLHs. Conversely, CNVs were more frequent in DLBCLs than in ocular adnexal MALT lymphomas. Copy number variations were detected in 77% (10/13) of orbital MALT lymphomas and in 67% (11/16) of conjunctival MALT lymphomas. High-resolution single nucleotide polymorphism array is a useful method for discriminating ocular adnexal lymphomas from benign LPDs. The differences in the chromosomal abnormality patterns may reflect the activity of ocular adnexal LPDs.

Diagnostic Pitfalls in “Low-Grade Lymphoma” of the Orbit and Lacrimal Gland

Aims: To investigate potential diagnostic pitfalls associated with the identification of low grade lymphoma in the orbit and lacrimal gland region.Methods: To systemically review all cases diagnosed as low grade lymphoma of orbit and lacrimal gland within a 2 year period at a specialist ophthalmic centre. To ascertain the frequency of diagnostic errors in this group of cases, in particular to look for known pitfalls associated with follicular colonisation by marginal zone lymphoma and the recently identified atypical variant of follicular lymphoma (FL). A series of 21 cases were reviewed.Results: We identified two diagnostic errors; one case of extra nodal marginal zone lymphoma (ENMZL) which showed follicular colonisation and was misinterpreted as a FL and a case of missed mantle cell lymphoma (MCL). We identified no cases of atypical FL.Conclusion: Within the orbit and lacrimal gland the term “low grade lymphoma” encompasses the following types of lymphoma: ENMZL, FL, MCL and chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL). The typical and atypical immunophenotype of these entities is discussed. The diagnosis of ENMZL, by far the most common low grade lymphoma to occur in these areas, is to some extent a difficult diagnosis and is often one of exclusion. The pitfalls of follicular colonisation and the concept of atypical follicular lymphoma are discussed.

Outcome of primary orbital lymphoma treated with induction chemotherapy followed by conformal radiotherapy

PurposeTo analyze the clinical outcome of primary orbital lymphoma (POL) patients treated with a combined modality approach with local radiotherapy after induction chemotherapy. MethodologyWe retrospectively retrieved demographic, treatment and outcome data of patients treated for POL from 2000 to 2010. The charts were reviewed and the data were tabulated in a predesigned pro-forma. Results23 patients of POL were found evaluable. Median age was 55years (range 24–70years). Of 23 patients, 15 were male and 8 female, making the male:female ratio approximately 1.9:1. Patients were thoroughly evaluated and staged. All but one patient received multi agent chemotherapy. Radiotherapy was delivered for all cases. Radiation was delivered by 3DCRT technique. Median dose of radiation was 45Gy (range 20–45Gy). Median follow up was 26.8months. None of the patients had any evidence of local failure or systemic progression. ConclusionA combined modality therapy with a combination of CHOP/COP based chemotherapy and moderate dose of radiotherapy imparts excellent long term local and systemic disease control.

PET/CT Findings in a Case With FDG-Avid Disseminated Lacrimal Gland MALToma With Sequential Development of Large B-Cell Lymphoma and Gastric MALToma

Primary orbital lymphomas are rare; the major histopathologic type is extranodal marginal-zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) or MALToma. We present a case of a 79-year-old female patient with FDG-avid lacrimal gland MALToma with nodal and pulmonary involvement (stage IVE). Nasopharynx and gastric involvement were detected on restaging F-FDG PET/CT after rituximab therapy, and it was found to have a site of transformation to diffuse large B-cell lymphoma (DLBCL) in the nasopharynx. Gastric MALT lymphoma was also confirmed histopathologically, and she then underwent combination chemotherapy regimen, resulting in regression after 3 courses.

Long-term outcomes and patterns of failure in orbital lymphoma treated with primary radiotherapy

The purpose of this study was to evaluate the long-term outcome and patterns of failure in patients treated with primary radiotherapy (RT) for orbital lymphoma (OL). Seventy-nine patients diagnosed with stage IE OL between 1995 and 2012 were included. Fifty-nine patients (75%) had mucosa-associated lymphoid tissue lymphoma and 20 patients (25%) had follicular lymphoma subtype. The median follow-up was 49.7 months. Major tumor sites were conjunctiva (29%), orbit (47%) and lacrimal gland (24%). After treatment to a median dose of 30.6 Gy, there were a total of no local, one contralateral orbital, two regional and two distant recurrences, all outside of the treatment fields. The 10-year local relapse-free, distant metastasis-free and overall survival rates were 100%, 94.2% and 98.2%, respectively. Definitive RT to 30 Gy was shown to be highly effective for indolent OL, and this study represents one of the largest single-institution studies using primary RT for stage IE OL.

IMRT for Orbital MALT Lymphoma: A Case Report and a Review of the Literature

Orbital lymphoma is rare and accounts for less than 1% of non-Hodgkins lymphomas (NHLs) throughout the body. Marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) type ise the most common histological type involving the orbit. MALT lymphomas are indolent, and usually respond well to local radiotherapy (RT). Results from RT series demonstrated excellent and durable local control and survival rates in patients with localized orbital MALT lymphoma. However, due to the rarity of the disease, data about optimal radiation dose from comparative studies are not available and, moreover, in reports with a substantial number of treated patients, doses in the range of 20 and 57 Gy were found to be used. The optimal radiation dose for treating this tumor is controversial. This case is presented because of rare incidence of orbital maltoma and to evaluate the effectiveness of RT in our Radiation Oncology department.

A Case of Orbital MALT Lymphoma in a Patient with Rheumatoid Arthritis

Purpose: To report a case of orbital mucosa-associated lymphoid tissue (MALT) lymphoma that occurred in a patient with rheumatoid arthritis (RA). Case summary: A 70-year-old male with alleged RA presented with a 3-month history of spontaneous and painless upper and lower eyelid swelling in the right eye. On initial examination, palpable nodules were observed at the right upper and lower eyelids and orbital computed tomography (CT) revealed a contrast-enhancing nodule just inferior to the lacrimal gland, thus an incisional biopsy was performed. The pathological report showed malignant orbital lymphoma (low grade extranodal marginal zone B cell lymphoma of MALT). Since distant metastases were not detected on whole-body CT and positron emission tomography, the patient was advised to keep previous medication and regular follow-up examinations. Conclusions: The possibility of MALT lymphoma should be considered as a differential diagnosis in patients with eyelid swelling and autoimmune diseases such as RA. J Korean Ophthalmol Soc 2015;56(5):780-783

IMRT for Orbital MALT Lymphoma: A Case Report and a Review of the Literature

IMRT for Orbital MALT Lymphoma: A Case Report and a Review of the Literature

Immunoglobulin G4-related disease (IgG4-RD) in the orbit: mucosa-associated lymphoid tissue (MALT)-type lymphomas.

BackgroundMALT lymphomas were classified for differential diagnostics of IgG4-dependent disease due to their exceptional predilection to intraorbital localization. Therefore, the goal of our studies was large retrospective analysis of patients diagnosed with MALT lymphomas within the orbital tissues, since no such studies have been conducted in Poland.Material/MethodsThe starting study population consisted of 167 patients with isolated infiltrative tumor diseases within the orbital region treated at the Department of Otolaryngology, Head and Neck Surgery of the Medical College Jagiellonian University in Cracow. The immunohistochemical assays using anti-IgG, anti-IgG4 and anti-CD138 antibodies were used to estimate the IgG4+/CD138+ and IgG4+/IgG+ ratios.ResultsOf all the studied and analyzed patients, a final group of 19 patients with orbital MALT lymphomas was selected to undergo diagnostic examinations for IgG4-related disease. Detailed analysis and diagnostic screening for IgG4-related disease was performed and results meeting the criteria of IgG4-dependent disease were obtained in 10 out of 19 patients with the diagnosis of MALT tumor established on the basis of immunohistochemical assays.ConclusionsMALT lymphomas are the most common of all lymphomas occurring within orbital tissues. In this study, results consistent with the criteria of IgG4-related disease were obtained in approximately 50% patients with immunohistochemical diagnosis of orbital MALT lymphoma.

Outcomes of Primary Lymphoma of the Ocular Adnexa (Orbital Lymphoma) Treated with Radiotherapy

AimsLow-grade ocular adnexal lymphoma is a rare disease and often treated with local radiotherapy to varying doses. Most previously reported studies have a very heterogeneous patient population and treatments. We report the outcomes from a 10 year cohort of patients at our institution treated with primary radiation therapy. Materials and methodsWe analysed a retrospective case series of patients with stage IE low-grade ocular adnexal lymphoma including a review of case notes, histological reports and radiotherapy charts. We assessed local and distant tumour control and relapse rates in addition to toxicity. Disease-free survival was estimated using the Kaplan–Meier method. ResultsIn total, 81 patients and 85 orbits were treated with primary radiotherapy to a median dose of 30 Gy in 15 fractions over 3 weeks. Seventy-nine per cent were treated with standard MV external beam radiotherapy to the whole orbit and 21% with a lens-sparing technique. The median follow-up was 4.4 years (range 0.2–10.4). Local control rates were 100%, with 5% of patients experiencing disease relapse elsewhere. No patients died from lymphoma. Cumulative acute toxicity rates were 51% (mainly erythema and conjunctivitis) and late toxicity rates were 8% (mainly cataract). The lens-sparing technique was associated with a significant reduction in cataract rate (P = 0.013) and an increase in acute toxicity (P < 0.001). ConclusionsThis study has shown excellent local control rates and acceptable toxicity from the treatment of stage IE low-grade ocular adnexal lymphoma with localised radiotherapy to a median dose of 30 Gy in 15 fractions over 3 weeks.

P11.03 * OPTIC NERVE INFILTRATION OF PRIMARY CNS LYMPHOMA

BACKGROUND: Visual impairment in Primary CNS lymphoma (PCNSL) in most of the cases is due to an intraocular lymphomatous involvement, especially uveitis. Optic nerve infiltration (ONI) in PCNSL is a rare condition. We sought to describe its clinical presentation, imaging characteristics, and outcomes. METHODS: Patients with ONI of PCNSL were retrospectively identified from 1998 to 2014 from the databases of the university hospitals Pitie-Salpetriere (Paris) and Rene Huguenin (Saint-Cloud), and the academic teaching hospital Pasteur (Colmar), France. Exclusion criteria were intraocular involvement, orbital lymphoma, or other systemic lymphoma. Clinical presentation, neuroimaging, biological features, treatment and outcomes were assessed from their medical records. RESULTS: Only 6 of 710 PCNSL were identified as presenting ONI. Patients' median age at presentation was 65 years (49-78), 5 were women. 2 patients had ONI at initial diagnosis, 3 at 1st relapse after HD-MTX based chemotherapy, and 1 at 2nd relapse after HD-MTX, salvage chemotherapy and high-dose chemotherapy with autologous stem cell transplant. Clinical presentation: Rapidly progressive visual impairment without red eyes (6/6 patients), painless (4/6), unilateral (4/6), bilateral (2/6), bilateral hemianopia (2/6). MRI: Optic nerve swelling (3/6), contrast-enhancement of the entire ON (5/6) or of the ON sheath (1/6); Localization of ONI: Chiasmic (3/6), cisternal (3/6), intracanalicular (3/6), and intraorbital (4/6). Additional CNS lesions were seen in 4/6. Systemic lymphoma was excluded in all patients; lumbar puncture was done in 4/6 proving leptomeningeal disease in 2. Median delay from symptom onset to treatment: 25 days (10-140). Treatment: Different chemotherapy regimens were administered but lymphoma recurred in the majority. Clinical outcome: Partial recovery (2/6 patients), persisting low vision or blindness (4/6). Radiological outcome: Complete remission (4/6), partial remission (1/6), stable disease (1/6). Median PFS after ONI: 11 months (3-11), OS: 32 months (12-40). CONCLUSIONS: Intraocular involvement is observed in about 15% of PCNSL, clinically marked by slowly progressive visual deterioration over several months, usually caused by posterior uveitis. Lymphomatous infiltration of the optic nerve is characterized by a rapidly progressive severe visual impairment. In patients with ONI as initial presentation of PCNSL, it is difficult to establish the diagnoses as differential diagnosis are broad. In these patients, optic nerve biopsy should be discussed only in absence of cerebral lesions. At relapse, clinical presentation, neuroimaging and the absence of intraocular involvement may help to establish the diagnosis. As optic nerve functional outcome is poor, rapid treatment might improve clinical outcome. ACKNOWLEDGEMENTS: LOC national network (INCa).

Primary Orbital Lymphoma: A Rare Presentation of NHL

Non Hodgkins Lymphoma (NHL) is a malignant neoplasm of lymphoid tissue representing 5% of all malignant tumors and one of the commonest haematological malignancy in our country. The disease can involve in any organ commonly in lymph nodes, liver, spleen, brain, eye, testis, thyroid. Orbital lymphoma is comprised about 1% of all NHL. This is a case report of a patient age of 50 years from Daudkandi, Comilla admitted in Chittagong Medical College Hospital with history of gradual non tender swelling in the left eye with no other organ involvement or any B symptoms. The objective of this study to consider orbital lymphoma as differential diagnosis of orbital swelling as it can occur almost any part of the body and is to minimize the delay of diagnosis as well as to improve prognosis. We analyzed the history, examination, investigations &amp; histopathology and immunohistochemistry of orbital growth that showed Non Hodgkin Lymphoma (Low Grade). The Patient was treated with consecutive six cycle R-CHOP (Rituximab, Cyclophosphamide, Adriamycin, Vincristine, Prednisolone) resulting in complete remission of lymphoma.&#x0D; JCMCTA 2014 ; 25 (1): 41-43

Clinical features, treatment and outcome of mucosa-associated lymphoid tissue (MALT) lymphoma of the ocular adnexa: single center experience of 60 patients.

BackgroundOrbital marginal zone B-cell lymphoma (OAML) constitutes for the most frequent diagnosis in orbital lymphoma. Relatively little data, however, have been reported in larger cohorts of patients staged in a uniform way and no therapy standard exists to date.Material and MethodsWe have retrospectively analyzed 60 patients diagnosed and treated at our institution 1999–2012. Median age at diagnosis was 64 years (IQR 51–75) and follow-up time 43 months (IQR 16–92). All patients had undergone uniform extensive staging and histological diagnosis was made by a reference pathologist according to the WHO classification.ResultsThe majority of patients presented with stage IE (n = 40/60, 67%), three had IIE/IIIE and the remaining 17 stage IVE. Seven patients with IVE had bilateral orbital disease whereas the others showed involvement of further organs. Treatment data were available in 58 patients. Local treatment with radiotherapy (14/58, 24%) or surgery (3/58, 5%) resulted in response in 82% of patients. A total of 26 patients (45%) received systemic treatment with a response rate of 85%. Nine patients received antibiotics as initial therapy; response rate was 38%. Watchful-waiting was the initial approach in 6/58 patients. In total 28/58 patients (48%) progressed and were given further therapy. Median time-to-progression in this cohort was 20 months (IQR 9–39). There was no difference in time-to-progression after first-line therapy between the different therapy arms (p = 0.14). Elevated beta-2-microglobulin, plasmacytic differentiation, autoimmune disorder and site of lymphoma were not associated with a higher risk for progress.ConclusionOur data underscore the excellent prognosis of OAML irrespective of initial therapy, as there was no significant difference in time-to-progression and response between local or systemic therapy. In the absence of randomized trials, the least toxic individual approach should be chosen for OAML.

Bilateral Lacrimal Gland Disease: Clinical Features of 97 Cases

Bilateral lacrimal gland (LG) disease is a unique presentation that can result from varied causes. We reviewed the diagnoses, clinical features, and outcomes of 97 patients with this entity. Case series. Ninety-seven patients with bilateral LG disease. Retrospective review and statistical analysis using analysis of variance and the Fisher exact test. Patient demographics, clinical features, diagnostic testing, diagnosis, and treatment. Patient age ranging from 8 to 84 years (mean, 46 years). The predominant gender was female (77%), and race included black (49%), white (38%), and Hispanic (12%) patients. Diagnoses fell into 4 categories: inflammatory (n = 51; 53%), structural (n = 20; 21%), lymphoproliferative (n = 19; 20%), and uncommon (n = 7; 7%) entities. The most common diagnoses included idiopathic orbital inflammation (IOI; n = 29; 30%), sarcoidosis (n = 19; 20%), prolapsed LG (n = 15; 15%), lymphoma (n = 11; 11%), lymphoid hyperplasia (n = 8; 8%), and dacryops (n = 5; 5%). Inflammatory conditions were more likely in younger patients (P<0.05) and in those with pain (P<0.001) and mechanical blepharoptosis (P<0.01) at presentation, whereas lymphoma was more common in older patients (P<0.001) without active signs of inflammation at presentation. Black patients were more likely to have sarcoidosis (P<0.01). Laboratory results showed high angiotensin converting enzyme level being significantly more likely in patients with sarcoidosis (P<0.05). However, sensitivity was limited to 45%, with 25% of patients diagnosed with IOI also demonstrating positive results. Corticosteroid therapy was the treatment of choice in 38 cases, corresponding to resolution of symptoms in 29% and improvement in an additional 32%. Overall, chronic underlying disease was found in 71% of patients, among whom 26% achieved a disease-free state, whereas 3% succumbed to their underlying disease. The cause of bilateral lacrimal gland disease most commonly was inflammatory, followed by structural and lymphoproliferative. Patient characteristics and clinical presentations were key features distinguishing between competing possibilities. Despite local control with corticosteroids or radiotherapy, underlying disease continued in 71% of patients and led to death in 3%.

Orbital lymphoproliferative disorders (OLPDs): value of MR imaging for differentiating orbital lymphoma from benign OPLDs.

Accurate discrimination of orbital lymphoma from benign orbital lymphoproliferative disorders is crucial for treatment planning. We evaluated MR imaging including DWI and contrast-enhanced MR imaging for differentiating orbital lymphoma from benign orbital lymphoproliferative disorders. Forty-seven histopathologically proved orbital lymphoproliferative disorders (29 orbital lymphomas and 18 benign orbital lymphoproliferative disorders) were evaluated. Two board-certified radiologists reviewed visual features on T1-weighted, fat-suppressed T2-weighted, diffusion-weighted, and contrast-enhanced MR images. For quantitative evaluation, ADC and contrast-enhancement ratio of all lesions were measured and optimal cutoff thresholds and areas under curves for differentiating orbital lymphoma from benign orbital lymphoproliferative disorders were determined using receiver operative characteristic analysis; corresponding sensitivities and specificities were calculated. Multivariate logistic regression analysis showed that ill-defined tumor margin (P = .003) had a significant association with orbital lymphoma whereas the "flow void sign" (P = .005) and radiologic evidence of sinusitis (P = .0002) were associated with benign orbital lymphoproliferative disorders. The mean ADC and contrast-enhancement ratio of orbital lymphomas were significantly lower than those of benign orbital lymphoproliferative disorders (P < .01). An ADC of less than 0.612 × 10(-3) mm(2)/s and a contrast-enhancement ratio of less than 1.88 yielded areas under curves of 0.980 and 0.770, sensitivity of 94.1% and 95.5%, and specificities of 93.3% and 80.0% for predicting orbital lymphoma, respectively. Some characteristic MR imaging features and quantitative DWI and contrast-enhanced MR imaging are useful in further improving the accuracy of MR imaging for differentiation of orbital lymphoma from benign orbital lymphoproliferative disorders.

Crystal-Storing Histiocytosis Masquerading Ocular Adnexal Lymphoma

A case of crystal-storing histiocytosis (CSH) associated with mucosa-associated lymphoid tissue (MALT) lymphoma of orbit is reported. The patient was a 53-year-old man who presented with an 8-year history of a slowly enlarging tumor in his right orbit. Histopathologic examination revealed that the tumor was composed predominantly of sheets of spindle-shaped cells resembling striated muscle cells and scattered aggregates of atypical lymphoid cells, showing prominent plasmacytoid differentiation. Immunohistochemical analysis demonstrated that the spindle-shaped cells were CD68-positive histiocytes containing abundant crystals in their cytoplasm, consistent with the diagnosis of CSH. The aggregates of atypical lymphoid cells were diagnosed as MALT lymphoma based on their immunophenotype. Although CSH is a well-recognized manifestation in lymphoproliferative disorders, CSH complicated by MALT type of ocular adnexal lymphoma has rarely been reported. Given the rarity of this, every case presenting with such crystal-storing histiocytes warrants a thorough search for a hidden lymphoid dyscrasia.

Mucosa-Associated Lymphoid Tissue Lymphoma Masquerading as Herniated Orbital Fat

Lymphomas are the most common primary orbital malignancies in adults. The authors present a 62-year-old Hispanic woman with a 2-year history of slowly enlarging bilateral lower eyelid masses that the patient described as "bags." On palpation, firm, mobile, nontender masses with associated tear trough deformities were noted. Biopsy of the left lower eyelid mass was consistent with a mucosa-associated lymphoid tissue lymphoma. Herniated orbital fat is an extremely common finding in the aging population and is often associated with a prominent tear trough. The patient with orbital lymphoma appeared to have herniated orbital fat with associated tear trough deformities. Lymphoma resembling herniated orbital fat is uncommon but should be considered in all patients with prominence in the periorbital region.

Orbital lymphoma associated with Graves’ disease: A case report

The presence of bilateral exophthalmos and palpebral, periorbital edema associated with hyperthyroidism is most often considered as an initial sign of Graves' ophthalmopathy. However, in up to 20% of cases, Graves' ophthalmopathy might precede the occurence of hyperthyroidism, which is very important to be considered in the differential diagnosis, especially if it is stated as unilateral. Among other less common causes of non-thyroid-related orbitopathy, orbital lymphoma represents rare conditions. We presented of a patient with Graves' disease, initially manifested as bilateral orbitopathy and progressive unilateral exophthalmos caused by the marginal zone B-cell non-Hodgkin lymphoma of the orbit. A 64-year-old man with the 3-year history of bilateral Graves' orbitopathy and hyperthyroidism underwent the left orbital decompression surgery due to the predominantly left, unilateral worsening of exophthalmos resistant to the previously applied glucocorticoid therapy. A year after the surgical treatment, a substantial exophthalmos of the left eye was again observed, signifying that other non-thyroid pathology could be involved. Orbital ultrasound was suggestive of primary orbital lymphoma, what was confirmed by orbital CT scan and the biopsy of the tumor tissue. Detailed examinations indicated that the marginal zone B-cell non-Hodgkin lymphoma extended to IV - B-b CS, IPI 3 (bone marrow infiltration: m+ orbit+). Upon the completion of the polychemiotherapy and the radiation treatment, a complete remission of the disease was achieved. Even when elements clearly indicate the presence of thyroid-related ophthalmopathy, disease deteriorating should raise a suspicion and always lead to imaging procedures to exclude malignancy.

Radiotherapy for orbital lymphoma

Abstract Lymphoma of the orbit is a rare presentation of non- Hodgkin's lymphoma (NHL). According to the data from the literature, orbital lymphoma represents 8% of all extranodal NHL and about 1% of all NHL [1-