Abstract
A patient presented with 6 weeks of progressive right eyelid swelling and binocular diplopia without systemic symptoms. Examination showed superior globe displacement, a firm inferolateral mass, and restricted motility. MRI revealed a heterogeneously enhancing extraconal lesion initially favored to be a cavernous venous malformation. Intraoperative findings suggested a more infiltrative process, prompting extensive biopsy. Pathology confirmed diffuse large B cell lymphoma, non GCB subtype, with BCL 2 rearrangement and high proliferative index. The patient was referred for systemic staging and R CHOP chemotherapy. This case emphasizes the need to consider lymphoma even when imaging suggests benign orbital pathology.
Presentation Date: 03/19/2026
Issue Date: 03/27/2026
