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The report details an 87-year-old man with sudden eyelid swelling, severe pain, progressive vision loss, and elevated intraocular pressure that ultimately deteriorated to no light perception. Orbital biopsy and immunohistochemistry confirmed non-Hodgkin diffuse large B-cell lymphoma with CD20 and Bcl-6 positivity. Combined chemotherapy and radiotherapy improved swelling and pain but did not restore vision. The case highlights the prognostic impact of early accurate diagnosis and recommends considering lymphoma in unilateral ocular hypertension resistant to standard therapy.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/primary-orbital-lymphoma-manifesting-as-increased-intraocular-pressure-a-case-report/452352/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/primary-orbital-lymphoma-manifesting-as-increased-intraocular-pressure-a-case-report/452352.png","ImageObject",300,407,{"name":92,"@type":93},"SANS","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What unusual symptom characterizes the case of primary orbital lymphoma?","Question",{"text":112,"@type":113},"The initial and predominant symptom was substantially increased intraocular pressure, which can mimic refractory glaucoma and mislead management.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the lymphoma diagnosis confirmed?",{"text":117,"@type":113},"An orbital mass biopsy showed small cell malignancy, and immunohistochemistry demonstrated CD20 and Bcl-6 positivity consistent with diffuse large B-cell lymphoma.",{"name":119,"@type":110,"acceptedAnswer":120},"What treatment was given and what was the outcome?",{"text":121,"@type":113},"The patient received combined chemotherapy and radiotherapy. Swelling and pain improved, but vision did not recover and deteriorated to no light perception.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},452352,1790765441,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},962090760505,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","e-ISSN 1941-5923  \n© Am J Case Rep, 2025; 26: e951048 DOI: 10. 12659/AJCR.951048  \nReceived: 2025.08.07  \nAccepted: 2025.10.16  \nAvailable online: 2025.11.14  \nPublished: 2025.12.19  \nAuthors’ Contribution: Study Design A  \nData Collection B Statistical Analysis C Data Interpretation D Manuscript Preparation E Literature Search F Funds Collection G  \nAEG  \nF  \nB  \nF  \nBC  \nBC  \nA  \nCorresponding Author: Financial support: Conflict of interest:  \nPrimary Orbital Lymphoma Manifesting  \nas Increased Intraocular Pressure: A Case Report  \nMiaomiao Sun Zhaohui Xiong Yincong Xu Zhongyou Zhou Jiale Wu  \nJiangzhou Han Lina Zhao  \nLina Zhao, e-mail: [1198332998@qq.com](1198332998@qq.com)  \nHealth Commission of Hebei Province (No. 20250375) None declared  \nDepartment of Ophthalmology, First Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China  \nPatient: Male, 87-year-old  \nFinal Diagnosis: Non-Hodgkin diffuse large B-cell lymphoma  \nSymptoms: Eyelid swelling • ocular hypertension • severe pain • vision loss  \nClinical Procedure: —  \nSpecialty: Immunology • Ophthalmology  \nObjective: Unusual clinical course  \nBackground: Lymphoma can involve any orbital soft tissue (excluding bone) and may mimic other orbital diseases, often leading to misdiagnosis. Early diagnosis improves both disease management and patient survival. This rare case provides insights into the early diagnosis and treatment of orbital lymphoma.  \nCase Report: An 87-year-old Asian man presented with sudden swelling of the left eyelid, vision loss, and severe pain. His intraocular pressure increased, and vision eventually deteriorated to no light perception. Biopsy of the orbital mass revealed small cell malignancy. Immunohistochemistry showed CD20(+++), Bcl-6(+++), and other markers consistent with diffuse large B-cell lymphoma. The patient received combined chemotherapy and radiotherapy, which relieved swelling and pain but did not restore vision.  \nConclusions: Orbital lymphoma may present with or without systemic symptoms. Its clinical and imaging features often overlap with other orbital diseases, contributing to misdiagnosis. Pathogenesis plays a critical role in prognosis, emphasizing the importance of early diagnosis to improve outcomes. This case is among the few reported in which initial presentation included elevated intraocular pressure.  \nKeywords: Intraocular Pressure • Lymphoma, Large B-Cell, Diffuse • Vision Disorders  \nAbbreviations: DLBCL – diffuse large B-cell lymphoma; R-CHOP – rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone  \nFull-text PDF: [https://www.amjcaserep.com/abstract/index/idArt/951048](https://www.amjcaserep.com/abstract/index/idArt/951048)  \n2477  1  3  12  \nPublisher’s note: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher  \nThis work is licensed under Creative Common AttributionNonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)  \ne951048-1  \nIndexed in: [PMC] [PubMed] [Emerging Sources Citation Index (ESCI)][Web of Science by Clarivate]  \n[Sun M. et](Sun M. et) al:  \nLymphoma presenting with high intraocular pressure © Am J Case Rep, 2025; 26: e951048  \nIntroduction  \nPrimary ocular lymphoma, comprising primary intraocular lymphoma and primary orbital lymphoma, is a rare malignancy due to the limited presence of native lymphatic tissue in the orbit [1]. Orbital lymphoma represents approximately 10% of all orbital neoplasms and 2% of all lymphoid and extranodal lymphomas, making it the most common orbital malignancy in adults [2]. According to the conventional definition, primary orbital lymphoma is confined to orbital tissues such as the lacrimal gland, conjunctiva, or extraocular muscles, without in","cbCailNwmQUHtsg1","https://ap.wps.com/l/cbCailNwmQUHtsg1","pdf",1102849,"English","# Introduction\n# Case Report\n## Chief Complaints","[{\"question\":\"What unusual symptom characterizes the case of primary orbital lymphoma?\",\"answer\":\"The initial and predominant symptom was substantially increased intraocular pressure, which can mimic refractory glaucoma and mislead management.\"},{\"question\":\"How was the lymphoma diagnosis confirmed?\",\"answer\":\"An orbital mass biopsy showed small cell malignancy, and immunohistochemistry demonstrated CD20 and Bcl-6 positivity consistent with diffuse large B-cell lymphoma.\"},{\"question\":\"What treatment was given and what was the outcome?\",\"answer\":\"The patient received combined chemotherapy and radiotherapy. Swelling and pain improved, but vision did not recover and deteriorated to no light perception.\"}]","Primary Orbital Lymphoma Manifesting as Increased Intraocular Pressure - A Case Report | PDF",1790736954,18]