Orbital lymphoma versus reactive lymphoid hyperplasia: an analysis of the use of computed tomography in differential diagnosis.

Computed x ray tomography (CT) studies of 40 patients with proptosis or periorbital swelling, in whom biopsy showed lymphoma in 23 and reactive lymphoid hyperplasia in 17, were analysed in an attempt to identify radiological differences between the two conditions. The results indicate that homogeneity of an orbital mass is a sensitive but non-specific indication of lymphoma, 75% of lymphomatous masses and only 23% of reactive lesions being homogeneous. Bone destruction was seen only in cases of lymphoma, but was rare. Other radiological features of the mass or the affected orbital structures did not allow discrimination of tumour from a reactive lesion.