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            This report describes a case of cystic, extranodal, marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue of the orbital lobe of the lacrimal gland in a 70-year-old female. Initial clinical examination revealed bilateral dermatochalasis and a medial left upper lid contour deformity thought to be involutional ptosis. There was no suspicion for a mass lesion. Imaging and subsequent specialist clinical, pathologic, an immunochemical evaluation showed diagnostic features of cystic lacrimal gland orbital lobe MALT lymphoma. Clinical, radiographic, and immunohistopathologic and immunohistochemical findings are detailed. A review of the literature was performed and discussed. Cases of cystic MALT lymphoma isolated to the orbital lobe of the lacrimal gland are rare, with six cases reported in the literature.

The findings of this newly reported case provide a valuable addition to the small number of previously reported cases with a previously undescribed presentation mimicking involutional eyelid changes and no systemic autoimmune disease findings. It is important to consider this disease entity in the differential diagnosis for patients within this age group that present with eyelid morphology changes, especially if the changes have occurred over a short period of time.