재발 미만성 거대세포 림프종의 직접 침범에 의한 단독 눈돌림신경마비

• 영문명: Isolated Oculomotor Nerve Palsy due to Direct Invasion of Recurrent Diffuse Large B-Cell Lymphoma
• 발행기관: 대한안과학회
• 저자명: 강혜민 김혜영,Hae Min Kang, MD, Hye Young Kim, MD
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume53,number3, 482~485쪽, 전체 4쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2012.03.15

영문 초록

Purpose: Compared with multiple cranial nerve palsies, isolated nerve palsy is very rare in Non-Hodgkin’s lymphoma. We experienced a case of isolated oculomotor nerve palsy as the first sign of recurrent diffuse large B-cell lymphoma (DLBCL). Case summary: A 45-year-old woman visited the ophthalmology clinic with a one-month history of left upper eyelid ptosis and diplopia. She had a history of DLBCL of the nasopharynx and has been in complete remission for three years after systemic chemotherapy. Ophthalmologic evaluation showed ptosis of the upper eyelid, anisocoria, but no definite limitations in ocular movement. After six weeks, aggravated ptosis, exodeviation of the left eye in the primary position, and ocular movement limitations in all directions except abduction were observed. Brain magnetic resonance angiography taken four weeks earlier demonstrated no intracranial vascular lesion, but an enhancing lesion in the cistern along the left oculomotor nerve was shown in brain magnetic resonance imaging. We diagnosed isolated oculomotor nerve palsy due to direct invasion of recurrent DLBCL. Cerebrospinal fluid analysis revealed tumor cells, and follow-up MRI showed progression of lymphoma into the cavernous sinus. Conclusions: Although not common, isolated oculomotor nerve palsy can be the first sign of malignant lymphoma, even after complete remission. J Korean Ophthalmol Soc 2012;53(3):482-485

키워드

Diffuse large B-cell lymphoma, Isolated oculomotor nerve palsy, Recurrent non-Hodgkin’s lymphoma