NEURORADIOLOGY


Case 30:
Young male with proptosis. CT has been performed.

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Examination reveals soft tissue mass lesions involving the retroconic, and extraconal spaces of both orbits. Small soft tissue lesion is seen near the posterior wall of the right maxillary sinus. Minimal enhancement is noted on contrast examination.

Diagnosis

B-cell Non Hodgkin's lymphoma

Discussion

Classification of malignant lymphoma continues to evolve from increased understanding of normal lymphoid cell differentiation as well as from observations on behavior and response to therapy within lymphoma subtypes. B-cell differentiation of malignant cells accounts for the majority of lymphomas. Locations such as stomach, intestine, skin, endocrine and salivary glands, as well as central nervous system, account for the majority of sites in extranodal presentations. Primary soft tissue lymphoma is quite rare, the reported frequency depending on the strictness of definition. If the lymphoma remains localized to the soft tissue site, the prognosis is unusually good.

The incidence of orbital involvement by lymphoma is approximately 1%. The lacrimal gland is most often involved. Lymphoma can also present as an infiltrative process in the retroconic spaces that obliterate th

Dr. Bhujang Pai, Hinduja Hospital, Mumbai