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Objective To explore the application value of diffusion weighted imaging(DWI)and apparent diffusion coefficient(ADC)value in differential diagnosis of slightly higher T2 signal in inflammatory pseudotumor infiltrating lymphocyte and lymphoma of lacrimal gland.Methods According to the results of histopathology,a retrospective analysis of twenty patients with slightly higher T2 signal on MRI in lacrimal gland were divided into two groups:inflammatory pseudotumor infiltrating lymphocyte group(n=12)and lymphoma group(n=8).Whole-tumor regions of interest(ROIs)were drawn on all slices of the ADC maps to acquire the mean ADC value of massses(ADCm)and of the white matter of contralateral temporal lobe(ADCw)with b-value of 1000 s/mm2.The ADC ratio(ADCR)of the lesion to the control was calculated.Receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic value of ADCm and ADCR. Results The mean ADCm and ADCR of inflammatory pseudotumor infiltrating lymphocyte were(1.058 ± 0.514)× 10-3 mm2/s and 1.341 ± 0.642,respectively.The mean ADCm and ADCR of lymphoma(0.683 ± 0.215)× 10-3 mm2/s and 0.764 ± 0.231, respectively.Lymphoma had a significantly lower ADCm and ADCR than inflammatory pseudotumor infiltrating lymphocyte(P< 0.05).Setting the ADCm of 0.682 × 10-3 mm2/s and the ADCR of 0.834 as the cut-off value,the optimal diagnostic value could be achieved(AUC 0.852 ± 0.03,sensitivity 0.764,specificity 0.823,accuracy 0.901;AUC 0.812 ± 0.01,sensitivity 0.764, specificity 0.745,accuracy 0.837,respectively)in differentiating lacrimal gland of inflammatory pseudotumor infiltrating lymphocyte and lymphoma.Conclusions DWI and ADC value have an important reference value in differential diagnosis of slightly higher T2 signal in inflammatory pseudotumor infiltrating lymphocyte and lymphoma of lacrimal gland.