Orbital Lymphomas and Pseudolymphomas: A Clinicopathologic Study of Eleven Cases

Abstract

Kelly, Arthur G., Rosas-Uribe, Arturo, and Kraus, Stephen T.: Orbital lymphomas and pseudolymphomas. A clinicopathologic study of eleven cases. Biopsy specimens from six patients with malignant lymphomas and five with pseudolymphomas of the orbit and periorbital tissues were studied. Of the six malignant lymphomas, three were histiocytic; one, lymphocytic well-differentiated; another, mixed lymphocytic–histiocytic, and the sixth, Burkitt’s type. Five specimens showed the morphologic characteristics of pseudolymphomas. A case of granulocytic sarcoma (chloroma) was also included for comparison. The age range of the patients was 7 to 74 years. Seven were male and five, female. An average radiotherapy dose of 3,500 rads was given to the patients with lymphomas, except for one who received 1,500 rads. The patients who had pseudolymphomas were treated surgically, and two of them also recevied an average of 3,200 rads. Three patients with malignant lymphomas died, one accidentally, without evidence of the disease, and one with widespread lymphoma at four months. Two patients, one with histiocytic lymphoma and another with Burkitt’s lymphoma, had no evidence of disease at five years. The patient with the well-differentiated lymphocytic lymphoma is disease-free at eight months. The patients with pseudolymphoma are free of disease, having had one single and one double recurrence, from one month to five years. Histochemistry was used in all cases and electron microscopy in one to verify the precise nature of the malignant cells, as light microscopy revealed a malignant round cell tumor difficult to classify. The histologic features that differentiated lymphomas from pseudolymphomas of the orbit are reviewed in detail.