Primary marginal zone B-cell lymphoma of the cavernous sinus: a case report and review of the literature

Abstract

Background Primary lymphoma of the cavernous sinus is a rare form of extranodal non-Hodgkin lymphoma, of which very few cases have been reported in the published literature. This report presents the MRI findings with apparent diffusion coefficient (ADC) value in an exceedingly rare primary marginal zone B-cell lymphoma (MZBCL) of the cavernous sinus. Case presentation The case in this study is a 59-year-old immunocompetent male patient with a 2-month history of right ptosis and blurred vision. Right third cranial nerve palsy and binocular diplopia were observed upon neurological examination. Preoperative brain CT showed an extra-axial enhancing mass lesion in the right cavernous sinus. On MRI, ipsilateral internal carotid arterial encasement was noted without causing stenosis of the vessel. Isointense signal on T1-weighted and T2-weighted images, homogeneous contrast enhancement, and diffusion restriction were also observed. The mean ADC value of the tumor is 0.64 × 10–3 mm2/s (b value = 1000 s/mm2). Subtotal resection of the tumor was performed, and improvement of clinical symptoms were observed. The pathologic diagnosis of MZBCL was established by immunohistochemical examinations. Conclusions Primary MZBCL of the cavernous sinus is exceedingly rare, and preoperative confirmation poses a major challenge with CT and conventional MRI only. In this case, preoperative quantitative ADC value is shown to offer valuable additional information in the diagnostic process.

Diagnosis and Treatment of Low-Grade Marginal Zone B-cell Lymphoma With Psychiatric Overlap

“…The myriad medications introduced a significant complexity to his management, as the side effects of each drug could mimic or obscure the manifestations of his primary medical conditions. This required meticulous medication management and adjustments to ensure that symptoms were not being masked by drug effects, underscoring the necessity for thorough medication reviews in similar complex cases [3][4][5].…”

Primary central nervous system marginal zone lymphoma

“…Intracranial dural localizations mostly involve hemispheric convexities, 40 interhemispheric falx, 41,42 tentorium 6,[43][44][45] and cavernous sinus. 17,28,[46][47][48][49] The second most frequent site of involvement is the glomus of the choroid plexus in the lateral ventricles, a structure with ectodermal origin and devoid of a blood-brain barrier. 22,23,25,27,[49][50][51][52] Twenty-eight cases with parenchymal location of this tumour have been reported so far and are mostly localized in the cortex, 6,39,49,[53][54][55][56] basal ganglia, 26,28,[56][57][58] cerebellopontine angle 20,[59][60][61] and retina.…”

“…Usually PCNSMZL origins from the dura, but rare cases developing within CNS parenchyma may occur as well. Intracranial dural localizations mostly involve hemispheric convexities, 40 interhemispheric falx, 41,42 tentorium 6,43–45 and cavernous sinus 17,28,46–49 . The second most frequent site of involvement is the glomus of the choroid plexus in the lateral ventricles, a structure with ectodermal origin and devoid of a blood–brain barrier 22,23,25,27,49–52 .…”

PXR Activation Relieves Deoxynivalenol‐Induced Liver Oxidative Stress Via Malat1 LncRNA m6A Demethylation

“…[ 13 ] Recent studies have linked m 6 A modifications to liver diseases, such as fatty liver, [ 14 ] hepatitis, [ 15 ] cirrhosis, [ 16 ] and HCC. [ 17 ] Given the known involvement of m 6 A in liver diseases and its association with oxidative stress, [ 18 ] it is plausible that m 6 A modification may also play a role in DON‐induced hepatic oxidative stress and liver injury. Notably, the highly conserved region of Malat1 lncRNA contains clusters of m 6 A modifications.…”