Co-existence of intraocular and orbital lymphoma

Background: The concomitant occurrence of both intraocular and periocular lymphomas is extremely rare. Periocular involvement by lymphoproliferative disease ranges from benign lymphoid hyperplasia to malignant lymphoma. Intraocular lymphomas usually appear in conjunction with primary central nervous system lymphoma. Case Reports: We describe clinical characteristics, standardized A- and B-scan ultrasonography, colour Doppler, computerized tomographic and magnetic resonance imaging, and immunohistological findings in three cases of concurrent choroidal and periocular involvement of lymphoma. Discussion: The clinical presentation of diffuse choroidal tumours may be variable, making diagnosis of intraocular lymphoma troublesome on clinical grounds alone. The high accuracy of colour Doppler imaging is known to be effective in differentiating the benign from the malignant and adds valuable information in the differential diagnosis of a low reflective lesion. We suggest the use of auxiliary examinations such as ultrasonography and colour Doppler imaging to help in the differential diagnosis of choroidal and orbital tumours.