Immunoblastic B-cell malignant lymphoma involving the orbit and maxillary sinus in a patient with acquired immune deficiency syndrome.

Abstract

A 44-year-old man was diagnosed with acquired immune deficiency syndrome (AIDS)-related complex in 1986. Four years later, erythema and swelling of the right lower eyelid and face and a palpable mass along the right inferior orbital rim developed. Computed tomographic scans of the orbits disclosed a mass involving the right superior antrum and inferior orbit. Histopathologic examination and immunohistochemical studies of the tumor were performed. Immunohistochemical studies were performed on paraffin sections of the neoplasm. Markers used included leukocyte-common antigen and L26 (pan B-cell marker), and MT1, Leu22, polyclonal CD3, UCHL-1, and OPD4 (pan T-cell markers). Additional markers included cytokeratin, HMB-45, lysozyme, S-100 protein, kappa, and lambda. The neoplastic cells were strongly to moderately positive with LCA, L26, MT1, and Leu22. Negative staining was observed with the remaining nine antibodies. Orbital lymphomas in patients with AIDS have been rarely documented; those few reported cases showed a B-cell phenotype. The authors report an immunoblastic B cell with immunophenotypic coexpression of T-cell markers.