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case_images: (a) Close view (b) Full mouth view, swelling in palate bilaterally
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case_images: A 31-year-old gentleman reported to the Department of Maxillofacial Surgery with swelling in the palate bilaterally since 1 month [Figure 1].
case_images: Proptosis of the left eye
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case_images: These symptoms were followed by the proptosis of left eye [Figure 2] and paresthesia of the left side of the face.
case_images: CECT Abdomen showing (a) Liver with hypodense, hypoenhancing lesion in right lobe in segment 8 in close contact with Inferior Venacava and cardiac base. (b) Hypodense enhancing lesion in uncinated process of pancreas extending to pancreatico-duodenal groove and multiple small hyperdense lesions in both kidneys
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case_images: A CECT Abdomen was done, which showed the presence of liver and pancreatic lesions with the possibility of lymphoma metastasis [Figure 3].
case_images: X-Ray of the right hand with multiple punched out lesions in 5th metacarpal
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case_images: For the swelling of the right hand, X-ray was taken; it appeared as multiple punched out lesion on the 5th metacarpal [Figure 4].
case_images: MRI of hand showing lesion around 5th metacarpal with inflammation of tissues around it. (a) Coronal view. (b) Transverse view
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case_images: Following this, an MRI of the right hand was also done which confirmed the presence of a lesion in the 5th metacarpal with inflammation around it [Figure 5]. computerized tomography of paranasal sinus indicated complete mucosal thickening in bilateral maxillary antrum with mucosal thickening extending to the right nasal cavity and choana.
case_images: CT PNS showing complete mucosal thickening in bilateral maxillary antrum extending to right nasal cavity and choana. Also, mucosal thickening involving maxillary ostia and ethmoidal infundibulum causing obstruction of bilateral osteo-meatal unit with widening and erosion on the right side
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case_images: Also, mucosal thickening involving maxillary ostia and ethmoidal infundibulum causing obstruction of the bilateral osteo-meatal unit with widening and erosion on right side [Figure 6].
case_images: Diagnostic nasal endoscopy depicting presence of lymphoid tissue in nasopharynx
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case_images: Following this, a diagnostic nasal endoscopy was performed, suggesting the presence of lymphoid tissue in the nasopharynx [Figure 7].
case_images: PET CT showing lymphoma metastasis before and after chemotherapy
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