Zusammenfassung
Ein primäres Non-Hodgkin-Lymphom (NHL) des inneren Gehörgangs oder des Kleinhirnbrückenwinkels stellt auch unter den dort anzutreffenden ungewöhnlichen Prozessen eine absolute Rarität dar. In etwa 90–95% handelt es sich bei Raumforderungen im Kleinhirnbrückenwinkel und inneren Gehörgang um Schwannome oder Meningeome. Bei atypischen Symptomen oder einem rasch progredienten Verlauf sollten seltene Differenzialdiagnosen bedacht werden. Anhand klinischer Symptome oder der Bildmorphologie lässt sich die Diagnose eines Lymphoms jedoch nicht sichern. Bei entsprechendem Verdacht auf einen malignen Prozess im Rahmen der chirurgischen Exploration kann ein intraoperativer Schnellschnitt wichtige Hinweise für die adäquate Behandlung geben. Wir berichten über Verlauf, Diagnostik und Therapie eines seltenen Falles eines primären B-Zell-NHL des inneren Gehörgangs.
Abstract
A primary non-Hodgkin lymphoma (NHL) of the internal auditory canal or the cerebellopontine angle is an absolute rarity, even among the unusual lesions encountered there. Schwannomas or meningiomas account for approximately 90–95% of the tumors of the cerebellopontine angle and the internal auditory canal. Atypical symptoms, such as facial nerve palsy or rapid progression, require differential diagnostics to identify less frequent entities. However, clinical symptoms or the image morphology cannot confirm the diagnosis of a lymphoma. If a malignant process is suspected during surgical exploration, an immediate intraoperative biopsy can give important clues for appropriate treatment. The course, diagnostics, and therapy of a rare case of primary B-cell NHL of the internal auditory canal are reported here.
Literatur
Abrey LE, Moskowitz CH, Mason WP et al. (2003) Intensive methotrexate and cytarabine followed by high-dose chemotherapy with autologous stem-cell rescue in patients with newly diagnosed primary CNS lymphoma: an intent-to-treat analysis. Clin Oncol 21: 4151–4156
Bikmaz K, Cosar M, Kurtkaya-Yapicier O et al. (2005) Recurrent solitary fibrous tumour in the cerebellopontine angle. J Clin Neurosci 12: 829–832
Brackmann DE, Bartels LJ (1980) Rare tumors of the cerebellopontine angle. Otolaryngol Head Neck Surg 88: 555–559
Danchaivijitr N, Hesselink JR, Aryan HE, Herndier B (2004) Cerebello-Pontine angle (CPA) lymphoma with perineural extension into the middle fossa: case report. Surg Neurol 62: 80–85
Dazert S, Aletsee C, Brors D et al. (2005) Rare tumors of the internal auditory canal. Eur Arch Otorhinolaryngol 262: 550–554
Erdag N, Bhorade RM, Alberico RA et al. (2001) Primary lymphoma of the central nervous system: typical and atypical CT and MR imaging appearances. AJR Am J Roentgenol 176: 1319–1326
Huang TW, Young YH (2002) Differentiation between cerebellopontine angle tumors in cancer patients. Otol Neurotol 23: 975–979
Hustert B, Stoll W, August C (1997) Felsenbeintumoren: Das primäre Non-Hodgkin-Lymphom des inneren Gehörganges und Kleinhirnbrückenwinkels. Laryngorhinootologie 76: 625–628
Ierokomos A, Goin DW (1985) Primary CNS lymphoma in the cerebellopontine angle. Report of a case. Arch Otolaryngol 111: 50–52
Illerhaus G, Marks R, Ihorst G et al. (2006) High-dose chemotherapy with autologous stem-cell transplantation and hyperfractionated radiotherapy as first-line treatment of primary CNS lymphoma. J Clin Oncol 24: 3865–3870
Kohan D, Downey LL, Lim J et al. (1997) Uncommon lesions presenting as tumors of the internal auditory canal and cerebellopontine angle. Am J Otolaryngol 18: 386–392
Maher EA, Fine HA (1999) Primary CNS lymphoma. Semin Oncol 26: 346–356
Morrison GA, Sterkers JM (1996) Unusual presentations of acoustic tumours. Clin Otolaryngol 21: 80–83
Nishimura T, Uchida Y, Fukuoka M et al. (1998) Cerebellopontine angle lymphoma: a case report and review of the literature. Surg Neurol 50: 480–485; discussion 485–486
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Knapp, F., Rieh, E., Spreer, J. et al. Primäres B-Zell-Non-Hodgkin-Lymphom des inneren Gehörgangs. HNO 56, 633–637 (2008). https://doi.org/10.1007/s00106-007-1645-2
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DOI: https://doi.org/10.1007/s00106-007-1645-2