Characteristics of orbital lymphoproliferative disorders: a retrospective study of 84 cases.

Objective: To investigate the variations in clinical presentation, imaging characteristics, and immunohistochemical features between benign and malignant orbital lymphoproliferative disorders (OLPDs).

Methods: At the Eye Center of the First Affiliated Hospital, Zhejiang University School of Medicine, a retrospective analysis was performed on the clinical records of all patients diagnosed with OLPDs from 2014 to 2022. This study included a comparative analysis between patients diagnosed with benign and malignant OLPDs.

Results: A total of 84 patients were included in this research, with a mean age of 62.24 ± 14.52 years and male-to-female ratio of 43:41. The pathological types comprised benign orbital lymphoproliferative tumours (26/84, 31%, mean age 59.31 ± 10.4 years, male-to-female ratio of 16:10) and malignant orbital lymphomas (58/84, 69%, mean age 63.55 ± 15.93 years, male-to-female ratio of 27:31). The most common symptoms in benign and malignant OLPDs were palpable mass and eyelid swelling. Typically, malignant orbital lymphoma masses exhibited low signal intensity on T1-weighted imaging (T1WI), whereas benign lymphoproliferative tumours commonly demonstrated iso-intensity on T1WI. Notably, the expression of cluster of differentiation 3, 5, 10, 23, 43, and human immunoglobulin light chain lambda demonstrated statistically significant differences between the benign and malignant OLPD groups.

Conclusion: Benign and malignant OLPDs exhibit similar clinical presentations and imaging characteristics. Currently, distinguishing between benign and malignant OLPDs still requires pathological biopsy. Research on specialized imaging techniques and specific biomarkers for malignant orbital lymphomas is underway, showing potential for enhancing the accuracy of non-invasive diagnoses for benign and malignant OLPDs.