Involvement of cranial nerves in a patient with secondary central nervous system lymphoma

Azevedo, Roberta Dantas; Reis, Fabiano; Delamain, Márcia Torresan; Souza, Cármino Antônio de

doi:10.1016/j.bjhh.2016.02.001

Cited by 4 publications

(5 citation statements)

References 10 publications

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“…Given that DLBCL only accounts for only about 10–15% of all cases of orbital lymphoma according to most series, it was disproportionately associated with the presence of neurolymphomatosis in our series [ 24 ]. Similarly, Azevedo et al [ 5 ] reported that involvement of multiple CNs is rare in cases of DLBCL and Stacy et al [ 25 ] found that 57% of orbital DLBCL cases were restricted to the ocular adnexa. In contrast, marginal zone lymphoma which accounts for at least 60% of all cases of orbital lymphoma was seen in only 3 patients with neurolymphomatosis in our series [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

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Primary disease sites and patterns of spread in cases of neurolymphomatosis in the orbit associated with lymphoma

et al. 2021

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Background Neurolymphomatosis involving the cranial nerves (CNs) is rare. We sought a better understanding of the primary disease sites and patterns of spread in neurolymphomatosis of the orbit and retro-orbital cranial nerves. Methods Patients with lymphoma and MRI evidence of neurolymphomatosis of CN II, III, IV, V1, or V2 were retrospectively reviewed. Demographics and primary disease site and sites of neurolymphomatosis on MRI were recorded. Wilcoxon rank sum test was used to compare number of sites of neurolymphomatosis with lymphoma type and survival. Results The study included 18 patients. The most frequent types of lymphoma were diffuse large B-cell (DLBCL) (n = 9) and marginal zone (n = 3). In 9 patients, lymphoma presented as a mass (n = 7) or infiltrative disease (n = 2) directly involving the orbit; in 6, a maxillofacial mass spread directly to CNs; and in 3, lymphoma at remote sites spread to orbital CNs. Overall, 81 sites of neurolymphomatosis were noted. The most common sites were the maxillary nerve (V2) including at the infraorbital fissure or foramen rotundum (17 patients; 19 nerves), pterygopalatine fossa (16 patients; 19 nerves), and cavernous sinus (9 patients; 12 nerves). Number of sites of neurolymphomatosis was significantly lower for DLBCL than for other lymphoma types (p = 0.007). Number of sites of neurolymphomatosis did not affect survival (p = 0.26). The mean interval between the pathologic diagnosis and MRI documentation of the full extent of neurolymphomatosis was 39 days after pathologic diagnosis. Conclusions Based on our study results, neurolymphomatosis in the orbit appears to be frequently associated with an orbital and/or maxillofacial mass and commonly involves CN V2, the pterygopalatine fossa, and the cavernous sinus. DLBCL may be associated with fewer sites of neurolymphomatosis than other lymphomas. In patients with lymphoma, a systematic search for neurolymphomatosis is imperative for early detection.

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Section: Discussionmentioning

confidence: 99%

“…Neurolymphomatosis affects patients with NHL and lack of detection may lead to a delay in diagnosis [ 3 , 4 ]. The incidence of neurolymphomatosis is increasing worldwide, and this may be due to increased awareness and earlier detection with more sophisticated diagnostic techniques [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Primary disease sites and patterns of spread in cases of neurolymphomatosis in the orbit associated with lymphoma

et al. 2021

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“…Currently the treatment of neurolymphoma is unsatisfactory [3], and the lower penetration of chemotherapy into the nerve is probably due to the nerve-blood barrier, which can explain the poorer rates of survival.…”

Section: Discussionmentioning

confidence: 99%

“…The neurological signs in lymphoma can be caused by multiple mechanisms, subsequent to different drugs used for treatment (especially vinca alkaloids), to radiotherapy, as a paraneoplastic syndrome [1] consequent to compression, or to a direct invasion of the peripheral nerves [2]. They can be found as a recurrence of the lymphoma after treatment, or associated with a central nervous system lymphoma [3]. Usually multiple nerves are affected by this condition, and single nerve involvement is very rare.…”

Section: Introductionmentioning

confidence: 99%

Primary B lymphoma tumor of the ulnar nerve. Case report

Sita-Alb

Sobec

Fodor

2019

Medicine and Pharmacy Reports

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Primary lymphoma of a peripheral nerve is a very rare condition with only a few cases reported in the medical literature. Primary lymphoma of a peripheral nerve in the upper extremity was reported in only four cases in the English and French literature. We present a case of a 54-year-old man, in good health, without other medical conditions, who came to our unit complaining of paraesthesia in the ulnar territory of the hand. MRI investigation showed a mass situated in the ulnar nerve sheaths, in the lower third of the arm. Surgical exploration and excision were performed. Morphopathological results revealed a very uncommon tumor, a large B cell diffuse non-Hodgkin lymphoma, the second primary ulnar nerve lymphoma presented in the literature. Early diagnosis and a better understanding of the pathogenesis of these tumors may change medical and surgical strategies, with further enhancement of survival rates.

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“…In addition, neurological manifestations and cranial neuropathies due to LMD of DLBCL have been well documented, in cases not dissimilar from our patient. Some of these incidences include upper extremity weakness and acute dysphagia,19 isolated oculomotor nerve palsy,20 frontotemporal headaches and diplopia,21 and isolated abducens nerve palsy 22. Hence, the presentation of LMD in DLBCL is variable and oftentimes can be misdiagnosed.…”

Section: Discussionmentioning

confidence: 99%

Diffuse large B-cell lymphoma recurrence presenting as multiple, progressive cranial neuropathies

Goron

Devlin

Schwartz³

2019

BMJ Case Rep

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A 58-year-old man with a history of rheumatoid arthritis and stage IV diffuse large B-cell lymphoma, in complete remission with no evidence of residual disease on positron emission tomography/CT after completing six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone chemotherapy, presented with acute onset of dysphagia to solids and liquids. On further evaluation, his dysphagia was attributed to a vagus nerve palsy, and later during his admission, he developed rapidly progressing left facial and vestibulocochlear nerve palsies. Imaging studies displayed pathological enhancement of bilateral seventh and eighth cranial nerves, concerning for leptomeningeal recurrence of lymphoma. Cerebrospinal fluid analysis and flow cytometry were confirmatory, revealing markedly atypical monotypic CD19 positive B cells.

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Involvement of cranial nerves in a patient with secondary central nervous system lymphoma

Cited by 4 publications

References 10 publications

Primary disease sites and patterns of spread in cases of neurolymphomatosis in the orbit associated with lymphoma

Primary disease sites and patterns of spread in cases of neurolymphomatosis in the orbit associated with lymphoma

Primary B lymphoma tumor of the ulnar nerve. Case report

Diffuse large B-cell lymphoma recurrence presenting as multiple, progressive cranial neuropathies

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