In this issue of Orbit, Peleg et al. report the experience from Vancouver of the uncommon entity of secondary involvement of the orbit by malignant lymphoproliferative lesions (lymphoma and malignant myeloma) arising in or involving the paranasal sinuses. Lymphomas are the commonest malignancy to affect the orbit, and overall, there have been steady increases in the incidence of lymphoma for many decades, and this increase continues. Although patients with lymphoproliferative disease directly invading the orbit from the adjacent paranasal sinuses are uncommon, this diagnosis should be considered where imaging reveals a lesion involving both compartments associated with bone destruction.
Those specialists seeing such patients would usually first consider an epithelial malignancy arising from the sinuses and invading the orbit, but clearly lymphoproliferative disorders form a significant group of such malignancies, and with proper consideration of this possibility, biopsy and specimen handling can be directed towards establishing the correct diagnosis. As orbital specialists, we value contributions such as this paper, and it fills another small gap in the large jigsaw of orbital pathology.