Unilateral Orbital Lymphomas: A Structured Multidisciplinary Workflow for Diagnosis and Management

Purpose

To describe a structured multidisciplinary workflow for the diagnosis and management of unilateral orbital lymphoma and to illustrate its clinical application through representative cases from a tertiary referral practice. Despite advances in orbital imaging and hematopathology, no standardized framework currently integrates clinical assessment, quantitative MRI parameters, immunohistochemical subtyping, and systemic staging into a reproducible diagnostic-therapeutic pathway. Patients and methods: A stepwise workflow integrating clinical assessment, MRI with diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) measurement, histopathologic confirmation with immunohistochemistry (IHC), and 18F-FDG PET/CT staging was developed at a tertiary referral center through multidisciplinary consensus. The workflow was applied to six patients with biopsy-confirmed unilateral orbital lymphoma (marginal zone, n=3; follicular, n=2; lymphoplasmacytic, n=1), selected to represent the clinical and radiologic spectrum encountered in practice.