inflammatory orbital pseudotumor vs. orbital lymphoma

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diffusion-weighted magnetic resonance imaging (DWI) in differentiating orbital lymphoma from idiopathic orbital inflammatory pseudotumor. A 56-year-old male with acute sinusitis presented with left-sided orbital pain and blurring of vision. Axial T1-weighted image A shows hypointense signal involving the sclera of left eye, the related intra- and extraconal fat planes and the lateral rectus muscle. Coronal T2-weighted image B shows an extraconal mass involving the left lateral rectus muscle, the lacrimal gland with intraconal extension. Post-contrast T1 fat-saturated images C,D show homogeneous enhancement of the extraconal mass and its intraconal component. No diffusion-weighted restriction seen on DWI (b500) (E) and ADC (F). The ADC value for the lesion is 1.27 × 10 −3 mm2/ sec. FNAC of the mass proved to be left-sided orbital inflammatory pseudotumor

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diffusion-weighted magnetic resonance imaging (DWI) in differentiating orbital lymphoma from idiopathic orbital inflammatory pseudotumor. A 13-year-old male with acute pan-sinusitis; presented with right-sided dull aching orbital pain, mild proptosis and limited orbital gaze. Axial T1 image (A) shows diffusely enlarged right superior and medial recti with mild haziness of the right intraconal retro bulbar fat. Axial T2 image (B) shows diffuse enlargement of the right superior and medial recti muscles with mild hyperintense signal. No diffusion weighted restriction seen on DWI (b500) image (C) and ADC (D). The ADC value is 1.34 × 10−3 mm2/sec. Right-sided orbital inflammatory pseudotumor, Myositic type. Therapeutic trial with corticosteroids was done and the patient relieved after 5 weeks

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diffusion-weighted magnetic resonance imaging (DWI) in differentiating orbital lymphoma from idiopathic orbital inflammatory pseudotumor. A 35-year-old female patient with acute rhino-sinusitis presented with left-sided orbital pain, mild proptosis and limited orbital movement. Axial T1- and T2-weighted images of the left orbit A, B show a primarily extraconal mass involving the left medial rectus muscle with intraconal extension. No diffusion-weighted restriction seen on DWI (b500) image (C) and ADC (D). The ADC value for the mass is 1.09 × 10−3 mm2/s. Histopathologically proved left-sided orbital inflammatory pseudotumor by FNAC

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diffusion-weighted magnetic resonance imaging (DWI) in differentiating orbital lymphoma from idiopathic orbital inflammatory pseudotumor. A 23-year-old male patient with acute rhino-sinusitis presented with left-sided orbital pain, mild proptosis and limited orbital gaze. Coronal T1 A shows diffusely enlarged left superior, medial and lateral recti with mild stranding of the left retrobulbar fat. Coronal and sagittal T1 fat-sat post-contrast images B, C show homogeneous enhancement of these left orbital muscles. Axial non-contrast CT image bone window D reveals ethmoidal and sphenoidal mild sinusitis. No diffusion-weighted restriction seen on DWI (b500) E and ADC F. The ADC value is 1.05 × 10−3 mm2/sec. Left-sided orbital inflammatory pseudotumor, Myositic type; responded well 2 weeks after therapeutic trial with corticosteroids

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diffusion-weighted magnetic resonance imaging (DWI) in differentiating orbital lymphoma from idiopathic orbital inflammatory pseudotumor. A 34-year-old male patient with acute onset of right-sided dull aching orbital pain and limited orbital movement Coronal T2WI and T1WI images A, B show enlarged right inferior and lateral recti muscles displaying T1 and T2 isointense signal with minor similar changes involving the left inferior rectus muscle. Complementary non-enhanced CT coronal image C shows bulky right inferior muscle and to lesser extent right lateral rectus muscle. Contrast-enhanced sagittal T1 fat-saturated image D shows marked contrast enhancement of inferior rectus muscle bulk. No diffusion-weighted restriction seen on DWI (b500) (E) and ADC (F). The ADC value is 1.1 × 10−3 mm2/sec. Right-sided orbital inflammatory pseudotumor, Myositic type; responded well 2 weeks after therapeutic trial with corticosteroids

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diffusion-weighted magnetic resonance imaging (DWI) in differentiating orbital lymphoma from idiopathic orbital inflammatory pseudotumor. A 56-year-old female patient with long history of left-sided dull aching orbital pain, chronic visual loss of left eye and limited left orbital movement. Axial T1 A shows T1 hypointense infiltrative retrobulbar mass involving the left medial rectus muscle, as well as the related extraconal and intraconal fat planes and encasing the optic nerve. Axial T2 image B shows ill-defined T2 hypointensity of the lesion. Axial and coronal T1 post-contrast images (C and D) reveal homogeneous enhancement of the mass lesion. Evident diffusion restriction on DWI (b1000)/ADC (E, F). The ADC value is 0.76 × 10−3 mm2/sec (F). Pathologically proved left-sided retrobulbar lymphoma (NHL) encasing the left optic nerve

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diffusion-weighted magnetic resonance imaging (DWI) in differentiating orbital lymphoma from idiopathic orbital inflammatory pseudotumor. A 59-year-old female with right-sided dull aching orbital pain and limited right orbital movement. Axial T1 image A shows T1 hypointense infiltrative right retrobulbar intraconal mass involving the right medial rectus muscle, the related intraconal fat planes and inseparable from the optic nerve. Coronal T2 image B shows isointense signal of the lesion. Coronal T1 post-contrast image C reveals homogeneous enhancement of the retrobulbar lesion with possible invasion of the orbital roof. Axial T1 post-contrast image D shows similar infiltrative submucosal mass seen in the left maxillary sinus. Evident diffusion restriction on DWI (b1000)/ADC (E, F). The ADC value of 0.46 × 10−3mm2/sec. E Pathologically proved right-sided retrobulbar lymphoma (NHL) partially encasing the left optic nerve

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diffusion-weighted magnetic resonance imaging (DWI) in differentiating orbital lymphoma from idiopathic orbital inflammatory pseudotumor. A 57-year-old male bilateral dull aching orbital pain, epiphora and cervical lymphadenopathy. Axial T1 image A shows T1 hypointense infiltrative masses involving both lacrimal glands. Coronal T2 image B revealed hyperintense signal of the lesions. Sagittal T1 post-contrast C reveals homogeneous mild enhancement of the previously mentioned both lacrimal gland masses. (arrow) Coronal T1 post-contrast image D shows mild enhancement of the lacrimal gland lesions. Evident diffusion restriction on DWI (b1000)/ADC (E, F). The ADC value for the left mass is 0.53 × 10 −3mm2/ sec (F). Bilateral lacrimal gland lymphomas, proved by histopathology and hematological study

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diffusion-weighted magnetic resonance imaging (DWI) in differentiating orbital lymphoma from idiopathic orbital inflammatory pseudotumor. A 26-year-old female rapidly growing swelling in the lateral aspect of the left orbit, associated with proptosis, headache and dull aching left orbital pain and cervical lymphadenopathy. Axial T1 image A shows hypointense infiltrative mass involving the left lacrimal gland, the left extraconal fat, the lateral bony wall, the left side of skull base, as well as the roof of the left orbit, and has a related left frontal epidural component. Coronal T2 image B shows slightly hyperintense mass displacing the extraconal muscles and the left optic nerve infero-medially. Non-contrast complementary CT study soft tissue window C reveals bone destruction of the left lateral orbital wall, left orbital roof, and lesser wing of sphenoid bone (green arrows). Sagittal T1 post-contrast image D shows mild enhancement of the left orbital mass. Evident diffusion restriction on DWI (b1000)/ADC (E, F). The ADC value of 0.52 × 10−3mm2/sec. Pathologically proved left orbital extraconal infiltrative lymphoma

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diffusion-weighted magnetic resonance imaging (DWI) in differentiating orbital lymphoma from idiopathic orbital inflammatory pseudotumor. A 14-year-old male patient with history of rapid left-sided proptosis, swelling in the lateral aspect of the left orbit and dull aching left orbital pain. Initial orbital MRI with contrast was done. Axial T2-weighted image A shows hypointense infiltrative mass involving the left extraconal fat, the lateral bony wall, the left sphenoid bone and sinus, with left temporal epidural component. Axial FLAIR follow-up image B shows isointense signal with reduction in mass size and loss of its epidural component as compared to the initial MRI study. Coronal post-contrast T1-weighted image C shows an enhancing left lateral extraconal mass in the left orbit Follow-up coronal post- contrast T1-image D shows marked reduction in the mass size and enhancement. Evident diffusion restriction on DWI (b1000)/ADC (E, F). The ADC value of 1.12 × 10 −3mm2/s. Pathologically proved left orbital extraconal infiltrative lymphoma

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diffusion-weighted magnetic resonance imaging (DWI) in differentiating orbital lymphoma from idiopathic orbital inflammatory pseudotumor. Descriptive analysis of mean, SD and range of ADC values in both studied entities