Kalantri Siddhesh Arun, Nayak Akshatha, Datta Saikat, Bhattacharyya Maitreyee
Institute of Hematology and Transfusion Medicine, Medical College and Hospital Kolkata, Kolkata, West Bengal, India.
BMJ Case Rep. 2017 Aug 1;2017:bcr-2017-219670. doi: 10.1136/bcr-2017-219670.
Lymphoma patient presenting with isolated third nerve palsy is relatively rare, and diagnosis of underlying disease may be challenging. Until this date, less than 20 cases have been described in the literature. This is the case of a 3-year-old boy who presented to neurologist with ptosis of left eye for 8 days. On examination, abdominal mass was detected, and the child was referred to paediatric surgery department. Laparotomy and excision of the mass was done. Histopathology and immunohistochemistry of the mass confirmed it to be a case of Burkitt's lymphoma. At this point, the patient was referred to haematology department. Contrast-enhanced CT brain showed infiltration around left cavernous sinus. Patient was treated with two cycles of R-CODOX-M/R-IVAC. Ptosis improved completely within few days of starting chemotherapy. Follow-up positron emission tomography CT scan done after the second cycle of chemotherapy revealed no metabolically active disease.
以孤立性动眼神经麻痹为表现的淋巴瘤患者相对少见,潜在疾病的诊断可能具有挑战性。截至目前,文献中报道的病例不足20例。本文报道一名3岁男孩,因左眼上睑下垂8天就诊于神经科。检查时发现腹部肿块,该患儿被转诊至小儿外科。进行了剖腹手术并切除肿块。肿块的组织病理学和免疫组织化学检查证实为伯基特淋巴瘤。此时,患者被转诊至血液科。增强CT脑部扫描显示左侧海绵窦周围有浸润。患者接受了两个周期的R-CODOX-M/R-IVAC治疗。化疗开始后几天内上睑下垂完全改善。化疗第二周期后进行的正电子发射断层扫描CT随访显示无代谢活跃疾病。