Linfoma ocular primario vs celulitis orbitaria en tiempos de COVID-19 / Primary ocular lymphoma vs orbital cellulitis in times of COVID-19

Los tumores sólidos neoplásicos de tejido linfoide se caracterizan por proliferación acelerada de la porción linforreticular del sistema retículo endotelial, su incidencia mundial es de 4/100,000 prevalente en féminas entre 50-70 años, de etiología desconocida, asociado a helicobacter pylori, epstein barr y VIH. Clínicamente están presentes los síntomas B: fiebre, sudoraciones nocturnas, pérdida de peso, prurito y astenia. ausentes en el caso que nos ocupa de una paciente femenina de 46 años de edad que acudió a consulta de oftalmología por aumento de volumen a nivel de anejos de ojo izquierdo, proptosis indolora y disminución de la visión, con diagnóstico inicial de celulitis orbitaria tratada ambulatoriamente sin resolución. Se administró antibioticoterapia intravenosa sin mejoría clínica, se realizaron estudios complementarios de imagen radiológica, ultrasonido, resonancia magnética con evidencia de imagen tumoral de crecimiento antero lateral, desplazamiento de globo ocular, diámetro mayor de 57,3 mm, de características isointensas heterogéneas, secuencia T1 y flair, erosión de pared interna de orbita y la biopsia excisional informó linfoma primario de anexo ocular orbitario tipo no-Hodgkin. El abordaje acucioso con estudios complementarios para descartar neoplasias orbitarias en pacientes con celulitis orbitaria o dacriocistitis de evolución tórpida es necesario en todo momento, independiente de las condiciones atípicas de pandemia por COVID-19 que dificultan su manejo(AU)

Solid neoplastic tumors of lymphoid tissue are characterized by accelerated proliferation of the lymphoreticular portion of the reticulum endothelial system, their worldwide incidence is 4/100,000 prevalent in females between 50-70 years of age, of unknown etiology, associated with helicobacter pylori, epstein barr and HIV. Clinically, symptoms B are present: fever, night sweats, weight loss, itching and asthenia, absent in the present case of a 46-year-old female patient who came to the ophthalmology office due to increased volume at the level of the appendages. of the left eye, painless proptosis and decreased vision, with an initial diagnosis of orbital cellulitis treated outpatiently without resolution. Intravenous antibiotic therapy was administered without clinical improvement, complementary radiological imaging studies, ultrasound, magnetic resonance imaging were performed with evidence of an anterolateral growth tumor image, ocular globe displacement, diameter greater than 57.3 mm, heterogeneous isointense characteristics, T1 sequence and flair, erosion of the internal wall of the orbit and the excisional biopsy reported primary non-Hodgkin type orbital annex lymphoma. A careful approach with complementary studies to rule out orbital neoplasms in patients with orbital cellulitis or dacryocystitis of torpid evolution is necessary at all times, regardless of the atypical conditions of a COVID-19 pandemic that make its management difficult(AU)

Proptosis as initial manifestation of Burkitt's lymphoma with orbital involvement. / Proptosis como manifestación inicial de linfoma de Burkitt con afectación orbitaria.

CASE PRESENTATION: A 35-year-old woman without any known systemic disorder presented with a complaint of painful and rapidly increasing proptosis in her right eye. Based on the clinical, radiological, analytical and ophthalmological assessments, the diagnosis made was Burkitt's lymphoma in acquired immunodeficiency syndrome. CONCLUSION: Proptosis can be an unusual way of presenting with Burkitt's lymphoma associated with acquired immunodeficiency. This differential diagnosis is important because confirmation leads to a change in the vital prognosis of the patient.