# Identifying Chronic Lymphocytic Leukaemia and Small Lymphocytic Lymphoma: An Uncommon Case of Ocular Adnexal Lymphoma

## TL;DR

A rare case of ocular adnexal lymphoma presenting as eyelid swelling is diagnosed as chronic lymphocytic leukaemia/small lymphocytic lymphoma.

## Contribution

Highlights an uncommon presentation of CLL/SLL as ocular adnexal lymphoma in a patient from an Asian country.

## Key findings

- The patient's initial trauma diagnosis was ruled out, revealing a lobulated mass.
- Histopathology confirmed the diagnosis of chronic lymphocytic leukaemia/small lymphocytic lymphoma.
- Multidisciplinary management was crucial for optimal patient outcomes.

## Abstract

Chronic lymphocytic leukaemia (CLL) and small lymphocytic lymphoma (SLL) are typically classified and treated as different manifestations of the same disease. Compared to the Western hemisphere, this type of lymphoma is rare in Asian countries. They usually manifest as anaemia, organomegaly, or lymphadenopathy. Ocular adnexal lymphoma (OAL) is a rare presentation of lymphoma that can affect any part of the orbital region. We present a gentleman who sought treatment at our centre for this rare malignancy, with an atypical presentation of painless swelling over the upper eyelid. The initial diagnosis of hematoma secondary to trauma was swiftly discarded following surgery, revealing a lobulated mass. Subsequently, histopathological examination points towards a diagnosis of CLL/SLL. We illustrate the importance of multidisciplinary management with several departments, striving to achieve the best possible outcome.