J Korean Ophthalmol Soc.  2015 May;56(5):780-783. 10.3341/jkos.2015.56.5.780.

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

• Ahn CJ
• Kim NJ

• KMID: 2121180
• DOI: http://doi.org/10.3341/jkos.2015.56.5.780

Abstract

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.

Keyword

Autoimmune disease; Eyelid swelling; MALT lymphoma; Rheumatoid arthritis

MeSH Terms

Aged
Arthritis, Rheumatoid*
Autoimmune Diseases
Biopsy
Diagnosis, Differential
Eyelids
Follow-Up Studies
Humans
Lacrimal Apparatus
Lymphoid Tissue
Lymphoma
Lymphoma, B-Cell, Marginal Zone*
Male
Neoplasm Metastasis
Orbit*
Positron-Emission Tomography

Figure

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  Figure 1. External photography shows upper and lower eyelid swelling in the right eye.

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  Figure 2. Orbital computed tomographic scans. (A, B) 0.6 cm sized homogenously enhancing mass was found just inferior to the right lacrimal gland (arrows). (C, D) 0.9 cm sized homogeneously enhancing mass was also found in the inferolateral orbit (arrows).

Reference

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