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Figure 13.7 Lymphoma of the lacrimal gland: (a) moulding around the globe and extending into the surrounding fat and (b) levator/superior rectus muscle complex.

expand the neighbouring orbital wall if the bone is thin. Neither the CT nor the MRI characteristics are diagnostic for the condition, being indistinguishable from inflammation, and biopsy is mandatory.

As the contemporary tissue diagnosis and treatment of lymphoproliferative disease is

Figure 13.8 A patient with low-grade orbital and sinus lymphoma, (a) before and (b) at two months after local radiotherapy.

disease and usually require multiple cycles of chemotherapy. If there is significant impairment of orbital function (with, for example, optic neuropathy) then local radiotherapy provides a useful means to accelerate resolution of the orbital disease.

When the disease is confined to the orbit the visual prognosis is excellent and complications are unusual, but the overall mortality is variable. Review for at least 10 years is required, as systemic lymphoma can become evident for many years after the presentation of solely orbital disease.

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