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

Goron, Abby R; Devlin, Stephen; Schwartz, Stacy

doi:10.1136/bcr-2019-229988

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…Two hundred seventy-two articles reported on 553 patients with otologic manifestations of hematologic malignancies, of which 255 (93.8%) were case reports and of OECBM level V evidence and 17 (6.2%) were case series and of OECBM level IV evidence (Supplement 3, http://links.lww.com/MAO/B834; Supplement 4, http://links.lww.com/MAO/B835) (4,5,7–10,13,14,19–282). While the largest proportion of articles originated in the United States (n = 83, 30.5%), the literature spanned countries across all continents.…”

Section: Resultsmentioning

confidence: 99%

A Scoping Review of Otologic Manifestations of Hematologic Malignancies

Raymond,

Ottinger,

Rowley

et al. 2024

Otol Neurotol

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Objective To examine the otologic and neurotologic symptoms, physical examination findings, and imaging features secondary to hematologic malignancies. Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, databases, including PubMed, Scopus, and CINAHL, were searched for articles including patients with otologic manifestations of leukemia, lymphoma and multiple myeloma. Data collected included patient and study demographics, specific hematologic malignancy, timing and classification of otologic symptoms, physical examination findings, imaging features and methods of diagnosis. Pooled descriptive analysis was performed. Results Two hundred seventy-two articles, of which 255 (93.8%) were case reports and 17 (6.2%) were case series, reporting on 553 patients were identified. Otologic manifestations were reported on 307 patients with leukemia, 204 patients with lymphoma and 42 patients with multiple myeloma. Hearing loss and unilateral facial palsy were the most common presenting symptoms for 111 reported subjects with leukemia (n = 46, 41.4%; n = 43, 38.7%) and 90 with lymphoma (n = 38, 42.2%; n = 39, 43.3%). Hearing loss and otalgia were the most common presenting symptoms for 21 subjects with multiple myeloma (n = 10, 47.6%; n = 6, 28.6%). Hearing loss and unilateral facial palsy were the most common otologic symptoms indicative of relapse in subjects with leukemia (n = 14, 43.8%) and lymphoma (n = 5, 50%). Conclusion Hearing loss, facial palsy, and otalgia might be the first indication of a new diagnosis or relapse of leukemia, lymphoma, or multiple myeloma. Clinicians should have a heightened level of suspicion of malignant etiologies of otologic symptoms in patients with current or medical histories of these malignancies.

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Section: Resultsmentioning

confidence: 99%

A Scoping Review of Otologic Manifestations of Hematologic Malignancies

Raymond,

Ottinger,

Rowley

et al. 2024

Otol Neurotol

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“…However, vagus nerve palsy caused by DLBCL has been reported previously, and the soft palate dysmotility in the present case may have been caused by a similar mechanism. 18 ) Sarcopenia refers to the loss of muscle mass throughout the body associated with aging and malnutrition. It also affects the pharyngeal muscles.…”

Section: Discussionmentioning

confidence: 99%

A Case of Dysphagia and Dysarthria Improved by Flexible-palatal Lift/augmentation Combination Prosthesis

Hirasaki¹,

Takagi

Umeda

et al. 2023

PRM

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Background: Palatal augmentation prosthesis (PAP) and palatal lift prosthesis (PLP) have been used to improve dysphagia and dysarthria. However, to date, there are few reports on their combined use. We report a quantitative evaluation of the effectiveness of a flexible-palatal lift/augmentation combination prosthesis (fPL/ACP) based on videofluoroscopic swallowing study (VFSS) and speech intelligibility testing. Case: An 83-year-old woman was admitted to our hospital with a hip fracture. She developed aspiration pneumonia at 1 month after partial hip replacement. Oral motor function tests revealed a motor deficit of the tongue and soft palate. VFSS showed delayed oral transit, nasopharyngeal reflux, and excessive pharyngeal residue. The cause of her dysphagia was assumed to be pre-existing diffuse large B-cell lymphoma and sarcopenia. To improve the dysphagia, an fPL/ACP was fabricated and applied. It improved the patient’s oral and pharyngeal swallowing and speech intelligibility. In addition to prosthetic treatment, rehabilitation and nutritional support allowed her to be discharged. Discussion: The effects of fPL/ACP in the present case were similar to those of flexible-PLP and PAP. f-PLP assists in elevation of the soft palate and improved the nasopharyngeal reflux and hypernasal speech. PAP promotes tongue movement and results in improved oral transit and speech intelligibility. Therefore, fPL/ACP may be effective in patients with motor deficits in both the tongue and soft palate. To maximize the effect of the intraoral prosthesis, a transdisciplinary approach with concurrent swallowing rehabilitation, nutritional support, and physical and occupational therapy is necessary.

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“…The reported cases in the literature demonstrated the initial symptoms, and the primary site was mostly at the trigeminal nerve in the cranium [14][15][16]. In multiple spreading cases, it includes the spinal nerves [17][18][19]. Biopsies are often performed for definitive pathological diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Since the number of reported cases is limited, the ordinal progression and deterioration patterns for neurolymphomatosis are hardly determined. The treatment of neurolymphomatosis includes chemotherapy consisting of rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisolone (R-CHOP) or systemic methotrexate, in some cases followed by whole-brain radiation [15][16][17]19].…”

Section: Discussionmentioning

confidence: 99%

Facial Nerve Neurolymphomatosis That Extends to Both the Brainstem and Extracranial Regions

Kondoh,

Lee,

Higashino

et al. 2023

Cureus

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A 73-year-old female developed right facial paralysis of House-Brackmann (H-B) grade III and was diagnosed with Bell's palsy. After three months of steroid therapy, she developed progressive hearing loss, and an MRI revealed a tumor in the right internal auditory canal. Within a few months, the right facial nerve palsy recurred, and the patient was treated with Gamma Knife radiosurgery. The tumor in the irradiated region disappeared, but new dysphagia was observed, and a right parotid gland tumor was detected for the first time. Tumors of the right parotid gland and the digastric muscle of the jaw were surgically resected, and a diagnosis of diffuse large B-cell lymphoma was made. The tumor had invaded the cranial nerves and brainstem region, and the patient did not wish to undergo further medical therapy. This was a case of malignant lymphoma that started as facial paralysis and invaded the brainstem, and testing for possible lymphoma at an early stage prior to radiotherapy was desirable.

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

Cited by 4 publications

References 22 publications

A Scoping Review of Otologic Manifestations of Hematologic Malignancies

A Scoping Review of Otologic Manifestations of Hematologic Malignancies

A Case of Dysphagia and Dysarthria Improved by Flexible-palatal Lift/augmentation Combination Prosthesis

Facial Nerve Neurolymphomatosis That Extends to Both the Brainstem and Extracranial Regions

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