Painful ophthalmoplegia in a patient with a history of marginal zone lymphoma

A 73-year-old man with a history of marginal zone lymphoma was admitted to the emergency room for diplopia and ipsilateral headache. The Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) demonstrated intense and symmetrical hypermetabolism of the cave...

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Bibliographic Details
Published in:European journal of hybrid imaging 2021-10, Vol.5 (1), p.18-18, Article 18
Main Authors: Van Bogaert, C., Mathey, C., Vierasu, I., Trotta, N., Rocq, L., Wolfromm, A., De Wilde, V., Goldman, S.
Format: Article
Language:English
Subjects:
Bones
Case Report
Computed tomography
Diagnosis
Emergency medical care
Emergency medical services
Fluorine
Imaging
Immunoglobulin G
Lesions
Lymph nodes
Lymphoma
Medicine
Medicine & Public Health
Nuclear Medicine
Ophthalmoplegia
Painful ophthalmoplegia
Positron emission
Positron emission tomography
Radiology
Sinuses
Tolosa Hunt syndrome
Tomography
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Summary:A 73-year-old man with a history of marginal zone lymphoma was admitted to the emergency room for diplopia and ipsilateral headache. The Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) demonstrated intense and symmetrical hypermetabolism of the cavernous sinuses, and hypermetabolic lesions diffusely in the lymph nodes and bones. The diagnosis of high-grade relapse of lymphomatous disease was made. In this context, the homogenous and symmetric lesion of the cavernous sinuses, without any other encephalic or meningeal lesions, raised the hypothesis of a paraneoplastic origin. A plausible paraneoplastic link between the neuro-ophthalmological lesion and the malignant disorder is IgG4-related disease, a condition that may be associated with lymphoma. As in our case, this diagnosis is often presumptive because histopathological confirmation is difficult to obtain.
ISSN:2510-3636
2510-3636
DOI:10.1186/s41824-021-00113-2