We report a case of recurred systemic malignant lymphoma developed after the treatment for ocular adnexal benign reactive lymphoid hyperplasia.

A 71-year-old female visited our hospital for right upper eyelid swelling and proptosis that had been progressing slowly for 4 years. Orbital computed tomography (CT) showed enlargement of the bellies of lateral and superior rectus muscles in the right orbit, but other abnormal findings were not detected in the systemic evaluation. Through incisional biopsy, benign reactive lymphoid hyperplasia was diagnosed on histopathologic examination. Upper eyelid swelling and proptosis resolved after radiation therapy. Fifty-one months after the treatment of benign reactive lymphoid hyperplasia, the patient visited our hospital again for a painful mass that had developed in the left neck. On neck CT, it showed enlargement of the left cervical lymph node and asymmetrical thickening of the left oropharyngeal wall. Systemic MALT lymphoma was confirmed, and radiation therapy was performed. According to neck CT, four months after radiation therapy, the enlargement and thickening resolved.

Because there is a possibility of systemic malignant lymphoma after benign reactive lymphoid hyperplasia, continuous follow-up and repeated systemic evaluation should be required after treatment of ocular adnexal benign reactive lymphoid hyperplasia.