Is there a role for radiation therapy in the treatment of a lymphoproliferative disorder involving the orbit?
If so, what dose and fractionation would you recommend?
Answer from: Radiation Oncologist at Academic Institution
The great majority of lymphoproliferative disorders of the orbit turn out to be NHL when subjected to sophisticated pathologic evaluation, but even those which are considered benign lymphoid hyperplasia (LH) are often and successfully treated with radiotherapy. The dose of RT for low-grade lymp...
Answer from: Radiation Oncologist at Academic Institution
When I don't have pathology/flow/PCR reports diagnostic of malignancy, I have treated patients with "lymphoid atypia", "atypical lymphoid infiltrate", or "lymphoproliferative disorder" with symptomatic disease to 4 Gy in 2 fractions. I have a collection of such patients (about a dozen), almost all o...
Comments
Radiation Oncologist at CCare Dr. @Rachel A. Rabinovitch and Dr. @Leonard Prosni...
Radiation Oncologist at Duke University Medical Center One orbit, if no evidence of bilateral involvement...
Radiation Oncologist at University of Colorado School of Medicine As per Dr. @Leonard Prosnitz, single orbit.
Answer from: Radiation Oncologist at Community Practice
To confirm the diagnosis of orbital lesion, biopsy (monoclonal small B cell lymphoma) is needed. To differentiate the reactive LH from the atypical forms (IgG related diseases), advanced molecular tests such as IHC and PCR (rearrangement of IG heavy chain gene (JH) and/or light chain gene, [J kappa]...
Answer from: Radiation Oncologist at Community Practice
IgG4 related disease is also a potential cause of lymphoproliferative disorder, as noted in Dr. @Aruna Turaka's answer.
If a patient has IgG4 disease, would you still recommend radiation therapy, or suggest other treatment?
Comments
Radiation Oncologist at Penn State Milton S Hershey Medical Center If it is IgG4 related disease, the first line of t...