Multiple cranial nerve involvement as a presentation of primary central nervous system lymphoma: A case-based review

Modi, Tanvi; Verma, Mansi; Patkar, Deepak

doi:10.4103/ajns.ajns_110_21

Cited by 4 publications

(2 citation statements)

References 8 publications

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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%

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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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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“…Finally, a rare condition that may involve cranial nerves is neurolymphomatosis. It accounts for about the 3% of newly diagnosed non-Hodgkin’s lymphoma or leukemia cases [ 29 ]. Different manifestations are described, ranging from a painful polyneuropathy involving the cauda equina to cranial neuropathy and painless or peripheral mononeuropathy involving the sciatic nerve [ 30 ].…”

Section: Pathogenesis: Why Can Cranial Nerve Enhancement Occur?mentioning

confidence: 99%

Extra-axial cranial nerve enhancement: a pattern-based approach

Moltoni,

Romano,

Blandino

et al. 2023

Radiol med

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Cranial nerve enhancement is a common and challenging MRI finding that requires a meticulous and systematic evaluation to identify the correct diagnosis. Literature mainly describes the various pathologies with the associated clinic-radiological characteristics, while the radiologist often needs a reverse approach that starts from the radiological findings to reach the diagnosis. Therefore, our aim is to provide a new and practical pattern-based approach to cranial nerve enhancement, which starts from the radiological findings and follows pattern-driven pipelines to navigate through multiple differential diagnoses, guiding the radiologist to reach the proper diagnosis. Firstly, we reviewed the literature and identified four patterns to categorize the main pathologies presenting with cranial nerve enhancement: unilateral linear pattern, bilateral linear pattern, unilateral thickened pattern, and bilateral thickened pattern. For each pattern, we describe the underlying pathogenic origin, and the main radiological features are displayed through high-quality MRI images and illustrative panels. A suggested MRI protocol for studying cranial nerve enhancement is also provided. In conclusion, our approach for cranial nerve enhancement aims to be an easy tool immediately applicable to clinical practice for converting challenging findings into specific pathological patterns.

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High-grade B-cell lymphoma manifested as peripheral nerve injury: A case report

Luo,

Li,

Liu

2024

Medicine

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Rationale: High-grade B-cell lymphoma is highly malignant and progresses rapidly, often being at the intermediate or advanced stage with poor prognosis when detected. This disease involves the central nervous system in 9% to 45% of cases, while peripheral nerve injury is relatively rare. Patient concerns: A 42-year-old male was admitted to the hospital due to recurrent peripheral facial paralysis lasting for 8 months and weakness in both lower extremities lasting for 1 month. No other symptoms and signs were apparent. Diagnoses: Fluorescence in situ hybridization showed the following results: IgH/Bcl2 t(14:18)(q32;q21) chromosomal translocation: negative; Bc16 gene translocation: positive; and Myc(8;q24) chromosomal translocation: positive. The clonal gene rearrangement test for B-cell lymphoma was positive, and the clonal gene rearrangement test for T-cell lymphoma was negative.The patient was diagnosed with high-grade B-cell lymphoma. Interventions: The treatment plan included chemotherapy, targeted drug therapy, biological therapy, immunotherapy, etc. Outcomes: The patient who was followed up for 1 and 3 years had stable conditions and was able to take care of himself, with an mRS score of 1. Five years after the initial diagnosis, the patient experienced recurrence and systemic metastasis of high-grade B-cell lymphoma, ultimately dying from multiple organ failure. Lessons: Lymphoma manifests mainly as progressive impairment of multiple cranial nerves or recurrent alternating peripheral nerve injury complicated with elevated protein concentrations in cerebrospinal fluid; it can be easily misdiagnosed as chronic inflammatory demyelinating polyradiculoneuropathy. Performing lymph node biopsy for high-grade B-cell lymphoma as early as possible helps detect lymphoma in the early stage.

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Multiple cranial nerve involvement as a presentation of primary central nervous system lymphoma: A case-based review

Cited by 4 publications

References 8 publications

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

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

Extra-axial cranial nerve enhancement: a pattern-based approach

High-grade B-cell lymphoma manifested as peripheral nerve injury: A case report

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