Periorbital non-Hodgkin's lymphoma after blunt trauma

The head and neck region is the second most common site for the development of extranodal lymphomas. Richter′s syndrome (RS) involves the transformation of B-cell chronic lymphocytic leukemia (B-CLL) to an aggressive lymphoma, most commonly, diffuse large B-cell lymphoma (DLBCL). We report the case of a 62-year-old man who developed DLBCL in the periorbital region 2 months after blunt trauma to the site. The patient lacked other physical symptoms at the time of presentation. Bone marrow biopsy and immunophenotypic analysis revealed a Richter transformation of unknown B-CLL. RS frequently arises in lymph nodes or bone marrow and rarely presents with extranodal involvement. Chemotherapy resulted in total remission of the lymphoma and no relapse was observed in the 6-month follow-up period. This case demonstrates that the clinician must recognize that unresolved soft tissue swelling after a trauma may be caused by NHL.