Abstract

Natural killer (NK)/T-cell lymphoma is a rare malignancy accounting for less than 1 percent of all lymphomas in North America and Europe. Ocular manifestations frequently presented as orbital cellulites that does not improve with adequate antibiotics. We report a case of NK/T cell lymphoma with rare ocular manifestation that was initially confused with orbital cellulites and chronic sinusitis due to multiple negative biopsies. 92-year-old female presented with right eye vision loss, and ipsi lateral orbital swelling for four weeks. MRI demonstrated right intra-orbital extension to the orbital apex. Workups for infection and vasculitis were negative. Multiple biopsies with histopathology and flow cytology were unrevealing for malignancy. Patient failed to improve on antibiotics and steroids. Five months after the initial presentation, patient presented with the same complaint; however, the orbital mass had grown in size and involved the maxillary sinus and contra lateral side. Re-biopsy revealed positive CD 56 for NK lymphoma.