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Letter
Cutaneous presentation of orbital follicular lymphoma: clinical differential diagnosis with lymphocytoma cutis
  1. R Goyal,
  2. R J Motley,
  3. S D Dojcinov,
  4. C M Lane
  1. Department of Ophthalmology, Pathology and Dermatology, University Hospital of Wales, Cardiff, UK
  1. Correspondence to: Mrs R Goyal

https://doi.org/10.1136/bjo.86.5.596

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    Cutaneous involvement from primary orbital lymphoma is uncommon. We report a patient with follicular lymphoma of the orbit who presented initially with cutaneous lesions clinically resembling lymphocytoma cutis which subsequently proved to be metastasis from the orbit.

    Case report

    A 75 year old woman presented to the dermatologist with a 6–7 month history of lumps on the right and left ears. Examination revealed two soft erythematous nodules, 2–3 cm in diameter behind the right ear and similar symmetrical lesions in both conchal bowls (Fig 1⇓). There was no lymphadenopathy or hepatosplenomegaly. Full clinical examination, chest x ray, full blood counts, erythrocyte sedimentation rate, U&E, and liver function tests were normal. A biopsy was performed. The clinical impression was that of lymphocytoma cutis and the lesions were treated with intralesional steroids resulting in prompt resolution leaving behind only flat discoloured areas. However, histology showed a nodular dermal lymphoid infiltrate of centrocyte-like cells with only scanty scattered blasts. Immunophenotypically, the lesional cells were of B cell phenotype (CD20+, CD79a+, CD10+, bcl6+, CD5−, CD43−, CD23−), overall …

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