J Korean Ophthalmol Soc.  2007 Dec;48(12):1711-1715.

A Case of Ocular Adnexal Benign Reactive Lymphoid Hyperplasia Recurred as Systemic Malignant Lymphoma

• Jo YJ
• Park CJ
• Lee SB

Abstract

PURPOSE: We report a case of recurred systemic malignant lymphoma developed after the treatment for ocular adnexal benign reactive lymphoid hyperplasia.
CASE SUMMARY
A 71-year-old female visited our hospital for right upper eyelid swelling and proptosis that had been progressing slowly for 4 years. Orbital computed tomography (CT) showed enlargement of the bellies of lateral and superior rectus muscles in the right orbit, but other abnormal findings were not detected in the systemic evaluation. Through incisional biopsy, benign reactive lymphoid hyperplasia was diagnosed on histopathologic examination. Upper eyelid swelling and proptosis resolved after radiation therapy. Fifty-one months after the treatment of benign reactive lymphoid hyperplasia, the patient visited our hospital again for a painful mass that had developed in the left neck. On neck CT, it showed enlargement of the left cervical lymph node and asymmetrical thickening of the left oropharyngeal wall. Systemic MALT lymphoma was confirmed, and radiation therapy was performed. According to neck CT, four months after radiation therapy, the enlargement and thickening resolved.
CONCLUSIONS
Because there is a possibility of systemic malignant lymphoma after benign reactive lymphoid hyperplasia, continuous follow-up and repeated systemic evaluation should be required after treatment of ocular adnexal benign reactive lymphoid hyperplasia.

Keyword

Benign reactive lymphoid hyperplasia; Lymphoma; Orbital lymphoma

MeSH Terms

Aged
Biopsy
Exophthalmos
Eyelids
Female
Follow-Up Studies
Humans
Lymph Nodes
Lymphoma*
Lymphoma, B-Cell, Marginal Zone
Muscles
Neck
Orbit
Pseudolymphoma*

Figure

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  Figure 1. (A) There is enlargement of bellies of superior rectus muscle (arrow) and lateral rectus muscle on orbital computed tomography (CT) at the initial visit for the right eyelid swelling and proptosis. (B) Orbital CT shows the enlargement of belly of lateral rectus muscle (arrow).

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  Figure 2. Histopathologic findings of superior rectus muscle and lateral rectus muscle. (A) Photomicrograph of histopathologic specimen shows small lymphoid cells infiltration (hematoxylin-eosin stain, original magnification *400). (B) Immunohistologic staining for CD3 shows hyperproliferation of T cells (immunoperoxidase stain, original magnification *10). (C) Immunohistologic staining for CD20 shows hyperproliferation of B cell (immunoperoxidase stain, original magnification *40). Consequently, benign reactive lymphoid hyperplasia was diagnosed.

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  Figure 3. Neck computed tomography scan shows enlargement of left cervical lymph nodes (arrows) (A) and asymmetrical thickening of left oropharyngeal wall (arrow) (B) at the visit for the left neck mass.

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  Figure 4. Histopathologic findings of left cervical lymph nodes and left oropharyngeal wall. (A) Photomicrograph of histopathologic specimen shows small lymphoid cells and plasma cells infiltration (hematoxylin-eosin stain, original magnification ×400). (B) Photomicrograph shows negative immunohistologic staining for kappa light chain (immunoperoxidase stain, original magnification *200). (C) Photomicrograph shows strong and diffuse positive staining for lambda light chain (immunoperoxidase stain, original magnification *200). Consequently, monoclonal MALT lymphoma was diagnosed.

Reference

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