Ocular lymphoma: overcoming a diagnostic challenge with an endoscopic sinus approach

Abstract

Background: Ocular lymphomas are rare, indolent tumours that pose a diagnostic challenge. Patients may be asymptomatic or present with symptoms of increased orbital mass. An index of suspicion is required alongside an understanding of the diagnostics and staging required to facilitate expedited multi-disciplinary work-up and management.

Methods: A comprehensive literature review was performed. We present a series of three cases, each presenting their own diagnostic challenge.

Results: Although ocular lymphomas are notoriously difficult to diagnose histologically, our case series show procurement of a diagnostic histological sample using an image-guided endoscopic sinus approach.

Conclusions: Although not typically involved in the diagnosis or management, the otolaryngologist may encounter ocular lymphoma masquerading as sinus disease or with disseminated disease at other sites in the head and neck. Endoscopic sinus surgery is considered a safe, effective approach for achieving a histological diagnosis in these cases.

Keywords: Endoscopic; FESS; Functional endoscopic sinus surgery; Lymphoma; Ocular; Orbital; Sinus.