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A case of malignant lymphoma presenting as orbital apex syndrome and facial nerve palsy Fumiko Kishimoto 1 , Chiaki Fujii 1 , Takashi Furuse 2 , Akiko Ohyama 3 , Nami Shishido 3 , Tadashi Ohyama 4 , Daigo Niiya 4 , Hiroshi Ohtsuki 5 1Division of Ophthalmology, Ibara Municipal Hospital 2Department of Ophthalmology 2, Kawasaki Hospital, Kawasaki Medical School 3Ohyama Eye Clinic 4Department of Hematology, Okayama City Hospital 5Department of Ophthalmology, Okayama Saiseikai General Hospital pp.1169-1174
Published Date 2019/9/15
DOI https://doi.org/10.11477/mf.1410213261
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Abstract Objective:To report a case of diffuse large B-cell lymphoma(DLBCL)that began in the orbit and resulted in multiple cranial nerve impairment:the cervical lymph node(except for the central nervous system)was involved in the course of disease.

Case:The patient was an 88-year-old woman who developed ptosis and diplopia caused by left oculomotor nerve palsy and then recovered. After five months, she showed vertical diplopia, seemingly sagging eye syndrome, which progressed to multiple cranial nerve impairment involving the Ⅵ, Ⅲ, Ⅴ1-3, Ⅳ, Ⅶ, and Ⅱ cranial nerves of the left side. Post-contract T1-weighted MRI revealed enhancement of the left orbit, cavernous sinus, and middle cranial fossa. Histopathological examination of the right supraclavicular lymph node biopsy was performed, and the patient was diagnosed with DLBCL(Ann Arbor:Stage ⅡA).

Conclusion:In the presence of multiple cranial nerve impairment involving the orbit and cavernous sinus, malignant lymphoma should be considered and aggressively examined for systemic involvement.


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電子版ISSN 1882-1308 印刷版ISSN 0370-5579 医学書院

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