Tissue Necrosis in Epstein–Barr Virus-Negative Orbital Diffuse Large B-Cell Lymphoma

An 82-year-old man presented with a history of diplopia for 5 months and painful swelling of the left eyelids for 3 months. Imaging studies revealed a lesion involving the left extraocular muscles, orbital fat, and optic nerve. Laboratory investigations were negative for Epstein–Barr virus antiviral capsid antigens-immunoglobulin M. Initial biopsy of the lesion was performed and histopathologic examination revealed only necrosis with positivity of cluster of differentiation 20. This prompted a second biopsy of the involved left extraocular muscles and the orbital fat. The results of histopathological and immunohistochemical tests corresponded to Epstein–Barr virus-negative diffuse large B-cell lymphoma, germinal center B-cell type. Address correspondence and reprint request to Yasuhiro Takahashi, MD, PhD, Department of Oculoplastic, Orbital, and Lacrimal Surgery, Aichi Medical University Hospital, 1-1 Yazako-Karimata, Nagakute, Aichi 480-1195, Japan; E-mail: yasuhiro_tak@yahoo.co.jp Received 14 August, 2018 Accepted 11 November, 2018 The authors report no conflicts of interest. © 2019 by Mutaz B. Habal, MD.

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