PMC6293602_01
Clinical picture showing the extent of proptosis in the right eye
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F1
The proptosis was significant and restricting the right eye movement laterally [Figure 1].
T2-weighted sagittal and coronal MRI images showing hypointense and intraorbital lesion
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F2
Magnetic resonance imaging (MRI) of the orbit [Figures 2 and 3] revealed an intraconal 3 x 3 cm lesion, which was hypointense on T2 and uniformly enhancing on contrast.
Contrast T1 images showing homogenously enhancing mass lesion 3 x 3 cm in the right orbit in the intraconal location
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F3
Magnetic resonance imaging (MRI) of the orbit [Figures 2 and 3] revealed an intraconal 3 x 3 cm lesion, which was hypointense on T2 and uniformly enhancing on contrast.
(a) Intraoperative image after right superior orbitotomy and removal of orbital rim (b) Approach to the tumor (periorbita exposed) (c) Intraoperative image of tumor dissection from the periorbita
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F4
The patient was taken up for surgery with a right frontal craniotomy and superior orbitotomy [Figure 4a] with removal of superior orbital rim, roof, and superior wall of the orbit. The tumor was exposed from the posterior aspect after complete exposure with meticulous dissection and separation of the periorbita [Figure 4b and c].
(a and b) H and E staining of the histopathological specimen showing typical lymphoplasmacytic cells, suggesting extranodal marginal zone lymphoma
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F5
Histopathology with immunohistochemistry reported an extranodal marginal zone lymphoma [Figure 5] with dominance of CD20/CD79a/Pax5, expressing B lymphoid cells with substantial populations of peripherally differentiating plasma cells.