Acute Presentation of Nasal-Type Natural Killer/T-cell Lymphoma of the Orbit

Purpose An unusual case of nasal-type natural killer/T-cell lymphoma (NKTL) of the orbit is reported. Methods The clinical history, computed tomography, magnetic resonance imaging, and biopsy specimen of a 29-year-old man with a right orbital lymphoma were evaluated. Results The patient initially presented with conjunctival injection and had flu-like symptoms before developing right proptosis and reduced vision; imaging showed a diffuse infiltrative process throughout the orbit. Orbital biopsy revealed angiodestruction with prominent necrosis, and angiocentric lymphoma growth and lymphoma cells were positively stained for CD3, CD20, CD45RO, CD56, cytotoxic molecules (granzyme B and T-cell intracellular antigen-1), and Epstein-Barr virus. Conclusions NKTL is rare and may present acutely; the imaging findings presented serve to highlight the radiologic features of the disease.