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Lacrimal sac tumours are rare tumours in ophthalmology but may have serious complications when misdiagnosed. Lacrimal sac tumours can be either epithelial or non-epithelial tumours. Epithelial tumours account for 60-94% of tumours. Pseudostratified ciliated columnar epithelium lines the lacrimal sac. Squamous cell carcinoma, transitional cell carcinoma, mucoepidermoid carcinoma, oncocytic adenocarcinoma, adenoid cystic carcinoma and metastasis are the commonly occurring epithelial tumours. Inverted papilloma is a locally aggressive tumour. Non-epithelial tumours (25%) are rarer than the epithelial tumours. Lymphoproliferative, melanocytic, and mesenchymal tumours are the non-epithelial tumours, among which the lymphoproliferative tumours constitute 2-8%. Very rarely Non-Hodgkin's lymphoma can occur as a primary in the lacrimal sac. Melanoma can occur as a primary from the melanocytes of the lining in the lacrimal sac or as a secondary from the conjuctival melanoma. Kaposi sarcoma and rhabdomyosarcoma are the mesenchymal tumours. Here is a case of Non-Hodgkin's lymphoma occurring in the lacrimal sac in an 80-year-old male. The patient came with the chief complaint of swelling around the right eye for two months. On radiological examination computed tomography revealed a homogenous solid mass in the right medial canthus, causing bony erosions of the orbit and extending into the nasolacrimal canal. An incisional biopsy of the mass was consistent with the diagnosis of Non-Hodgkin's lymphoma which was further confirmed by immunohistochemistry. This unusual presentation and histopathological features are described. [ABSTRACT FROM AUTHOR]

Diffuse Large B-Cell Lymphoma (DLBCL) is the most common histological subtype of Non-Hodgkin's Lymphoma (NHL). Primary retroperitoneal DLBCL is uncommon and has seldom been reported. Extrinsic compression of the duodenum due to lesions originating from the retroperitoneum is also rare. We present a case of a 39-year-old man who presented with inability to tolerate oral intake, abdominal pain, an upper abdominal mass and postprandial bilious vomiting caused by a large DLBCL arising from the retroperitoneum causing extrinsic compression of the duodenum. The cause of compression was initially presumed to be a neoplasm arising from the uncinate process of the pancreas or duodenum because of its proximity to the uncinate process and apparent widening of the C loop of duodenum. Repeat Computed Tomography (CT) scans were obtained because of the rapid increase in the size of the mass, normal levels of tumour markers such as Cancer Antigen (CA) 19-9, Carcinoembryonic Antigen (CEA) and no evidence of jaundice in spite of the large size of the mass. It revealed encasement of the uncinate process of pancreas with no involvement of parenchyma of the pancreas, thereby mimicking a pancreatic tumour. The neoplastic lymphoid cells were positive for Leukocyte Common Antigen (LCA), Cluster of Differentiation (CD)20, CD10, B-cell Lymphoma 2 (Bcl-2) and were negative for Creatine Kinase (CK), CD23, CD30, Anaplastic Lymphoma Kinase (ALK) and cyclin D1, D3 and D5. The Ki67 proliferative index was greater than 95%. Retroperitoneal DLBCL although rare should be considered in cases of duodenal obstruction. [ABSTRACT FROM AUTHOR]