Two Cases of Burkitt's Lymphoma in the Orbit

ABSTRACT

PURPOSE: We report two cases of Burkitt's lymphoma involving the orbit. METHODS: A seven-month male presented with the chief complaint of a 15-day history of left upper lid swelling. Ocular examinations revealed left ptosis, inferior displacement of the left eyeball due to upper lid mass. Orbital MRI scan showed diffusely enhancing homogenous mass of the left orbit. Another twelve-month male visited our clinic with sudden onset of left proptosis, and his conjunctiva was exposed due to severe proptosis. Orbital MRI showed a mass on the medial portion of the contralateral eye, ipsilateral temporal bone and extradural space. In both cases, incisional biopsy was done. RESULTS: Histopathologically, the lesions were characterized by a uniform background of large round or oval lymphocytes with multiple prominent nucleoli. Large, pale staining, benign phagocytic histiocytes or macrophages were interspersed within the collection of neoplastic lymphocytes. They showed a "starry sky appearance" and were positive for immunohistochemical stain against Ki-67 antigens. CONCLUSIONS: Burkitt's lymphoma should be suspected and considered in the differential diagnosis for children with acutely progressing orbital mass.