Rare clinical presentation of diffuse large B-cell lymphoma as otitis media and facial palsy

Siddiahgari, Sirisha Rani; Yerukula, Pallavi; Lingappa, Lokesh; Moodahadu, Latha Subramanya

doi:10.4103/1817-1745.181252

Cited by 6 publications

(6 citation statements)

References 8 publications

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“…Our review shows that a wide variety of lymphoma subtypes can occur in the middle ear and can be either primary or secondary malignancy. Most patients diagnosed with NHL DLBCL of the middle ear are male adults, with one case reported in a two-year-old [ 4 ]. It is also observed that most patients present with symptoms of otalgia, otorrhoea, hearing loss, and facial palsy.…”

Section: Discussionmentioning

confidence: 99%

“…The gastrointestinal tract is the most common site of presentation of NHL, followed by the head and neck region. Involvement of the middle ear and temporal bone is rare, and few cases have been reported in the literature [ 2 - 4 ]. We present a case of extra-nodal DLBCL involving the middle ear and the challenges faced while managing the patient with a literature review on the disease.…”

Section: Introductionmentioning

confidence: 99%

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Otalgia and Facial Nerve Palsy: Common Symptoms Revealing the Uncommon Pathology of Middle Ear Lymphoma

Jumaat¹,

Gendeh²,

Mustapha³

et al. 2022

Cureus

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Lymphoma of the middle ear and mastoid is uncommon and is rarely diagnosed early. The clinical presentation occurs due to consequences of extensive progressive disease. It can manifest as benign middle ear pathologies such as otitis media; other presentations include facial nerve palsy, hearing loss, and vestibular dysfunction. We treated a case of a 38-year-old male who presented with extranodal involvement of diffuse large B-cell lymphoma (DLBCL) of the middle ear, mastoid, and temporalis muscle, which mimicked an acute otitis media complicated with facial nerve palsy and hearing loss. He has underlying mediastinal and cervical DLBCL diagnosed 20 months before the current presentation. He underwent cortical mastoidectomy and chemotherapy. Despite treatment, he succumbed to the disease. We discuss the clinical significance of middle ear lymphoma by reviewing similar cases in the literature. To conclude, refractory middle ear disease should alert the surgeon of a more sinister underlying pathology in a patient with malignancy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Otalgia and Facial Nerve Palsy: Common Symptoms Revealing the Uncommon Pathology of Middle Ear Lymphoma

Jumaat¹,

Gendeh²,

Mustapha³

et al. 2022

Cureus

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“… 3 In people, there are <30 cases of lymphoma of the middle ear reported in the medical literature. 7 – 13 Review of these cases suggests that non-Hodgkin lymphoma is most common, with an approximately equal distribution of B-cell and T-cell neoplasms. There are no reports of lymphoma affecting the middle ear in dogs.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, this appears to be a key historical component in nearly all previously reported cases of middle-ear lymphoma in cats and people. 1 – 3 , 6 , 7 , 10 – 12 A large majority of people entered remission once an accurate diagnosis was made and treatment was initiated. Thus, cases with presumed or confirmed chronic otitis media/interna that lack adequate response to antimicrobial therapy warrant further investigation to limit delay of appropriate treatment and prevent further progression of disease.…”

Section: Discussionmentioning

confidence: 99%

Extranodal non-B, non-T-cell lymphoma with bilateral tympanic bulla involvement in a cat

Kerns

Brakel

Premanandan

et al. 2018

Journal of Feline Medicine and Surgery Open Reports

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Case summaryA 9-year-old spayed female domestic shorthair cat with clinical signs suggestive of chronic recurrent otitis media and recent seizures was presented with multifocal nervous system disease, including bilateral central and/or peripheral vestibular, cerebellar and forebrain deficits. Prior to presentation, there was inadequate improvement after 6 weeks of treatment for bilateral middle ear effusion from which a highly susceptible Staphylococcus species was cultured. This was followed by the development of seizures. Results of a complete blood count and serum chemistry were unremarkable, and a previous feline leukemia virus/feline immunodeficiency virus ELISA was negative. The cat was hospitalized overnight and had multiple seizures. The following morning the cat’s mentation worsened, and the cat lost ventilatory drive after induction for anesthesia in preparation for MRI. A brain herniation event was suspected, and the cat was euthanized prior to further diagnostics. On post-mortem examination both tympanic bullae were filled with a soft, tan-colored material. Histologically, this material was composed of neoplastic lymphocytes. In addition, neoplastic lymphocytes were found in the leptomeninges, brain parenchyma, submandibular lymph nodes and pancreas. The neoplastic lymphocytes were negative for both B- and T-lymphocyte immunohistochemical markers and PCR for antigen receptor rearrangements failed to amplify target DNA, indicating non-B, non-T-cell lymphoma.Relevance and novel informationTo our knowledge, this is the first report of lymphoma with confirmed bilateral tympanic bulla involvement in the human and veterinary literature. Neoplasia should be considered in cases of middle-ear effusion that do not improve adequately with appropriate antimicrobial therapy.

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“…When the 24 literature cases were combined with our case, 4 classifications of lymphoid neoplasms associated with the temporal bone were noted, including 7 cases of B cell lymphoma, [6][7][8][9][10][11][12] 4 T cell lymphomas, [13][14][15][16] 4 BLs, [17][18][19] and 10 leukemias. [20][21][22][23][24][25] 17 of 25 patients were male.…”

Section: Literature Reviewmentioning

confidence: 99%

Primary Presentation of Pediatric Hematopoietic Malignancy in the Temporal Bone: Case Report and Review of the Literature

et al. 2020

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Malignancy of hematopoietic origin comprises a large portion of all pediatric malignancies; however, it is uncommon for patients with this condition to present only with symptoms related to temporal bone involvement. Here, we report a case of Burkitt Lymphoma of the temporal bone in an 8-year-old patient who initially presented with symptoms of acute otitis media. Additionally, we review the current literature on pediatric hematopoietic malignancy with primary temporal bone involvement and discuss the clinical presentation, management, and outcomes of these rare cases.

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Rare clinical presentation of diffuse large B-cell lymphoma as otitis media and facial palsy

Cited by 6 publications

References 8 publications

Otalgia and Facial Nerve Palsy: Common Symptoms Revealing the Uncommon Pathology of Middle Ear Lymphoma

Otalgia and Facial Nerve Palsy: Common Symptoms Revealing the Uncommon Pathology of Middle Ear Lymphoma

Extranodal non-B, non-T-cell lymphoma with bilateral tympanic bulla involvement in a cat

Primary Presentation of Pediatric Hematopoietic Malignancy in the Temporal Bone: Case Report and Review of the Literature

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