Radiology, Vol 185, 63-70, Copyright © 1992 by Radiological Society of North America
Periocular lymphoproliferative diseases: natural history, prognostic factors, and treatment
BA Erickson, GJ Harris, CA Enke, KJ Murray, BM Massaro, GA Hanson, RM Hansen, T Anderson and JF Wilson
Department of Radiation Oncology, Medical College of Wisconsin Affiliated Hospitals, Milwaukee 53226.
A study was undertaken to assess the natural history of periocular
lymphoproliferative diseases, identify key prognostic factors, and clarify
the role of orbital irradiation. Thirty-four patients with periocular
lymphoproliferative disease were treated with orbital irradiation between
1975 and 1990. Eight patients had atypical lymphoid infiltrate, and 26 had
malignant lymphoma. Forty-three eyes were irradiated with en-face electrons
or 6-MV photons. Five-year disease- free survival for all stages was 65%;
it was not significantly affected by bilaterality or site. Stage,
distinction between atypical lymphoid infiltrate and malignant lymphoma,
and working formulation grade were important prognostic indicators. A
complete response during irradiation was achieved in 24 of 43 (56%) eyes at
a median dose of 2,400 cGy, and a partial response was achieved in 19
(44%), with resolution at a median of 2.8 months. Patients with periocular
reactive lymphoid hyperplasia or atypical lymphoid infiltrate may have or
are at significant risk of developing lymphoma and dissemination. Local
treatment remains important; orbital irradiation achieves prompt local
control with acceptable morbidity.
