TECHNIQUE:  Routine cone beam computed tomography was performed from the mid orbits through the mandibular base.  Data was acquired as a volume acquisition and reconstructed in multiple planes.  No intravenous contrast was administered. Evaluation of soft tissues is somewhat limited by bone algorithm processing. 

Comparison:  None. 

Findings: 

Airway:   The paranasal sinuses are clear. The osteomeatal units are widely patent.  There is no evidence of bony sclerosis or erosion. The airway is widely patent. 

Orbits:   There are bilateral extraconal masses, right greater than left, involving the expected region of the lacrimal glands.  There is some bony remodeling.  No definite bony erosion is seen.  There is suggestion of involvement of the lateral rectus muscle on the right.  There is bilateral exophthalmus, right greater than left.  The globes appear normal on this exam. 

Oral Cavity:  Unremarkable. 

TMJ:  There is no evidence of fracture, dislocation, or significant degenerative change. 

Other:  No other significant findings.               

IMPRESSION:  Differential considerations for the bilateral orbital masses includes: Lymphoma, Sarcoidosis, Sjogren’s syndrome, or less likely pseudotumor given the bilaterality.   Recommend evaluation by primary care physician.