Isolated third cranial nerve ophthalmoparesis, an atypical form of presentation in non-Hodgkin's lymphoma.
Ophthalmoparesis of the third cranial nerve a rare presentation in non-Hodgkins lymphoma
DOI:
https://doi.org/10.35305/fcm.v4i.117Keywords:
Linfoma; oftalmoparesia; tercer par cranealAbstract
We present a patient with non-Hodgkin's lymphoma with isolated ophthalmoparesis of the III cranial pair. We describe the clinical, radiological and analytical characteristics of the cerebrospinal fluid that made the diagnosis difficult, in a 55-year-old man with C virus carriage, hepatocarcinoma in remission and ethylism. He presented with isolated right third cranial nerve palsy, with pupillary involvement. The initial MRI showed increased thickness and enhancement of this nerve. Cerebrospinal fluid analysis showed no pathological findings. In the following months, due to clinical progression, the MRI was repeated and showed evidence of extension of the lesion. New CSF samples showed pleocytosis and hyperproteinorrachia, with negative cytology, cultures and flow cytometry. A biopsy was decided which revealed type B non-Hodgkin's lymphoma. We conducted a literature search where we found to date 12 cases of isolated paralysis of the third pair as clinical presentation of this type of lymphoma, being a rare form and to be considered in certain patients.
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