双侧瞳孔散大作为霍奇金淋巴瘤的首发表现：一例报告。
Bilateral mydriasis as first manifestation of Hodgkin's lymphoma: a case report.
机构信息
Department of Neurology, Klinikum rechts der Isar, Technical University, Ismaningerstrasse 22, 81675, Munich, Germany.
Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University, Ismaningerstrasse 22, 81675, Munich, Germany.
出版信息
BMC Neurol. 2022 Dec 12;22(1):473. doi: 10.1186/s12883-022-02941-6.
BACKGROUND
Bilateral mydriasis is usually associated with severe brain stem damage or drug-induced sympathomimetic stimulation. Herein we report it as a unique neurologic complication of Hodgkin's lymphoma.
CASE PRESENTATION
A 23-year-old woman presented at our emergency department with dilated pupils unresponsive to light stimuli. MRI and CT scans showed bilaterally enlarged lymph nodes in the mediastinum and supraclavicular compressing the carotid artery on both sides. The histologic examination of lymph node biopsy specimens confirmed the diagnosis of Hodgkin's lymphoma.
CONCLUSION
Pathologies around the carotid artery causing oculosympathetic spasm should be considered among the possible causes of a mydriasis, especially when other common causes like brain stem impairment are excluded.
背景
双侧瞳孔散大通常与严重的脑干损伤或药物引起的拟交感神经刺激有关。在此，我们报告一例霍奇金淋巴瘤独特的神经并发症。
病例介绍
一名 23 岁女性因瞳孔散大就诊于我院急诊科，对光刺激无反应。MRI 和 CT 扫描显示双侧纵隔和锁骨上淋巴结肿大，两侧颈动脉受压。淋巴结活检的组织学检查证实了霍奇金淋巴瘤的诊断。
结论
颈动脉周围的病变导致眼交感神经痉挛，应作为瞳孔散大的可能原因之一加以考虑，特别是在排除其他常见原因如脑干损伤时。
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