Exophthalmos and Blindness Revealing a Non-Hodgkin’s Malignant Lymphoma Type B with High Grade of Malignancy

Abstract

Background: Non-Hodgkin’s lymphomas represent a heterogeneous group of haematological disorders characterized by a malignant monoclonal proliferation of the lymphoid system (B or T cells). Orbicatory lolisation is rare, it is seen mainly in adults. Case Report: We report the case of a 79-year-old patient with a high-grade NHML, revealed by blindness and left exophthalmos evolving for 3 months. Ophthalmological examination revealed left blindness with axil exophthalmos grade 1. MRI cranio-orbital objectified a left orbital processe lesion intra and extra conical associated with a mucosal thickening of the cavum with left necrotic jugulocarotidian adenopathies. A biopsy of the cavum and ADP objectified a NHML of type B with high grade of malignancy. Result: The patient was put on induction chemotherapy first before being placed on radiotherapy. The evolution was marked by the regression of the left exophthalmia. Conclusion: The NHML is characterized by an extreme clinical polymorphism, especially in the cervicofacial localizations, make the diagnosis difficult and lead to a delay in management.