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Cutaneous T-cell lymphoma of the eyelid in a patient with acquired immunodeficiency syndrome.

Cutaneous T-cell lymphoma (CTCL) is significantly less common than B-cell lymphoma in patients with acquired immunodeficiency syndrome (AIDS). Periocular involvement by CTCL usually occurs in the setting of more widespread plaque or tumor-stage disease; therefore, CTCL localized solely to the periocular region is rare. We report the case of a 38-year-old Hispanic woman with AIDS and an enlarging tumor of the left upper eyelid. The clinical differential diagnosis included various infections and neoplasms. Examination of an incisional biopsy specimen revealed a dense infiltrate of atypical lymphocytes that labeled as T cells with use of the immunoperoxidase technique. The tumor subsequently regressed with local radiotherapy. Eyelid CTCL is reviewed and the differential diagnosis of eyelid lesions is reviewed.