Hustert B, Stoll W, August C
HNO-Universitätsklinik Münster.
Laryngorhinootologie. 1997 Oct;76(10):625-8. doi: 10.1055/s-2007-997490.
We report about a primary Non-Hodgkin Lymphoma (NHL) of the internal auditory canal. The only previously known manifestations of a NHL in the temporal bone have been infiltrations or hemorrhagic complications due to a late manifestation or advanced systemic disease. Involvement of both temporal bones is typical.
The 60-year-old female patient complained of an acute one-sided deafness, accompanied by a high-pitched tinnitus, rotating vertigo, and paralysis of the left half of the face.
We found a deafness in the left ear, spontaneous nystaxis, which was interpreted as a deficiency in excitement of the vestibular organ, and a complete peripheral facial paralysis. Diagnostic imaging studies revealed a large, intrameatal solid mass in the temporal bone, measuring 1.2 x 0.8 cm. Histologic examination after translabyrinthine tumor removal demonstrated a centroblastic Non-Hodgkin Lymphoma. The following extensive interdisciplinary staging examination showed no other tumor manifestations; the CSF analysis was negative.
The uniqueness of this case lies in the detection of a primary nongeneralized centroblastic lymphoma of the internal auditory canal. In contrast to infiltrations of systemic NHL in the same location, in which the advanced disease is responsible for the bad prognosis, this isolated lymphoma of the internal auditory canal seems analogous to extranodal MALT Lymphomas with a better prognosis. The primary extranodal NHL of the temporal bone, not reported in previous studies, is discussed with regard to clinical symptoms, differential diagnoses, and therapeutic strategies.
我们报告一例内耳道原发性非霍奇金淋巴瘤(NHL)。颞骨中NHL先前已知的唯一表现是由于晚期表现或晚期全身性疾病引起的浸润或出血并发症。双侧颞骨受累是典型表现。
一名60岁女性患者主诉急性单侧耳聋,伴有高音调耳鸣、旋转性眩晕和左侧面部麻痹。
我们发现左耳耳聋、自发性眼球震颤,这被解释为前庭器官兴奋不足,以及完全性周围性面瘫。诊断性影像学检查显示颞骨内有一个1.2×0.8 cm的大的、肉状实性肿块。经迷路肿瘤切除术后的组织学检查显示为中心母细胞性非霍奇金淋巴瘤。随后进行的广泛的多学科分期检查未发现其他肿瘤表现;脑脊液分析为阴性。
该病例的独特之处在于发现了内耳道原发性非全身性中心母细胞性淋巴瘤。与同一部位全身性NHL的浸润不同,后者晚期疾病导致预后不良,而这种孤立的内耳道淋巴瘤似乎类似于结外黏膜相关淋巴组织淋巴瘤,预后较好。本文讨论了先前研究中未报道的颞骨原发性结外NHL的临床症状、鉴别诊断和治疗策略。