Sun Mo Yang, Jaeryung Oh (Seoul, South Korea)

Although there have been a few reported cases of nasal NK/T cell lymphoma, this is an unusual case of lymphoma presented with vague symptoms and misdiagnosed as conjunctivitis. A 58-year-old woman presented with no specific abnormality in left eye, except simple conjunctivitis. After 10 days she presented again with a complaint of decreased visual acuity, proptosis, and severe ocular pain in the left eye. A posterior segment examination revealed opacity of the media and blurring at the optic disc margin of the left eye. Computed tomography revealed proptosis due to swelling of the intraorbital contents. After otorhinolaryngology consultation, a biopsy from the epithelial erosion of the nasal septum confirmed a diagnosis of a nasal NK/T cell malignant lymphoma. She was treated with chemotherapy but had a highly aggressive clinical course and died 4 months later. In conclusion, although the orbital involvement of nasal NK/T cell lymphoma is extremely serious, it is not easy to diagnose because it is rare and has non-specific symptoms during its early stages. If a patient shows poor response to treatment and presents ophthalmologic symptoms and signs, such as proptosis, ocular pain and visual loss, a malignant lymphoma in the orbit should be considered.