Isolated Hypoglossal Nerve Palsy as a Presenting Symptom of Metastatic Peripheral T-Cell Lymphoma – not Otherwise Specified (PTCL–NOS): A Unique Case & a Review of the Literature

Abstract

Extensive and significant technological advancements have enhanced the sensitivity and accuracy of the pathologic classification, diagnosis, and therapeutics of lymphoma. These advances have prompted a more comprehensive understanding of neoplastic behavior and have led to improvements in both treatment and prognosis. This paper presents a comprehensive review of lymphoma and features a case report of a unique presentation of peripheral T-cell lymphoma – not otherwise specified that presented with isolated hypoglossal nerve dysfunction.

Molecular Mechanisms and Pathophysiological Significance of Eryptosis

“…The lipid-associated changes in membrane structure and properties change the entire signal transduction pathway, which may affect the cytoskeleton and plays major role in the premature destruction of RBCs [ 40 ]. The exposed PS on the erythrocyte cell membrane is recognized by circulating macrophages with specific phosphatidylserine receptors, which engulf and removal the erythrocyte from the circulation [ 39 , 41 , 42 ].…”

Primary pancreatic peripheral T‐cell lymphoma‐not otherwise specified mimicking acute pancreatitis: A case report and review of literature

“…16 Only a few studies have been published that specifically investigate the likelihood of CNS disease and relapse in PTCL. 34 The CNS-International Prognostic Index (CNS-IPI) does not consider primary lymphoma of the pancreas at elevated risk of CNS involvement. 35 Although PTCL affects the CNS in only around 4%-6% of patients, 34 Facchinelli et al 16 reported one in every five of their PPL patients showing CNS relapse or advancement.…”

“…34 The CNS-International Prognostic Index (CNS-IPI) does not consider primary lymphoma of the pancreas at elevated risk of CNS involvement. 35 Although PTCL affects the CNS in only around 4%-6% of patients, 34 Facchinelli et al 16 reported one in every five of their PPL patients showing CNS relapse or advancement. The Swedish Lymphoma Registry study identified GI tract involvement as a significant risk factor for CNS relapse in PTCL.…”

“…Only a few studies have been published that specifically investigate the likelihood of CNS disease and relapse in PTCL 34 . The CNS‐International Prognostic Index (CNS‐IPI) does not consider primary lymphoma of the pancreas at elevated risk of CNS involvement 35 .…”

Isolated Hypoglossal Nerve Palsy as an Early Symptom of a Granular Cell Tumor

“…Spontaneous isolated hypoglossal nerve palsy (HNP) is an exceedingly rare phenomenon and even when claimed to be isolated, detailed case reports most often describe either pain, meningeal signs and symptoms or cerebral and/or ocular ischemia [ 1 , 2 , 3 , 4 , 5 , 6 ]. This scarcity may be attributed to the close proximity of numerous important anatomical structures, which typically cause additional collateral symptoms rather than an isolated complaint.…”