Bilateral lower palpebral MALT lymphoma
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A 65-year-old man presented with a 2-month history of painless swelling of the lower eyelids bilaterally. He had had a permanent pacemaker inserted 4 years previously for the treatment of third-degree heart block. On physical examination, bilateral palpebral edema and palpable masses were identified (Panel A). Computed tomography (CT) of the head showed enlargement of both lower eyelids with no associated cervical lymphadenopathy. Excision biopsy of the palpebral tumor revealed mucosa-associated lymphoid tissue (MALT) lymphoma. Comprehensive physical examination revealed no other lesions. Localized MALT lymphoma of the lower eyelids was diagnosed. The patient was treated with radiation therapy, delivered in five daily fractions of 3.2 Gy, and had a complete response after the completion of radiation therapy (Panel B)...

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