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T-Lymphoblastic Leukemia/Lymphoma in the Left Cavernous Sinus

  • An-Guor Wang
Chapter

Abstract

A 49-year-old male patient presented with complaints of diplopia for 2 months. He had no past medical history of vascular disorders such as diabetes, hypertension, or hyperlipidemia. In addition, he also reported swelling sensation and flashing light in his left eye. The patient visited a local eye clinic and received focal laser treatment for retinal break in the right eye before coming to our clinic. At our clinic, he was found to have good visual acuity of 6/5 in both eyes. He could identify 15 plates in the right eye but 0 plate in the left eye with the Ishihara test. A prism cover test revealed right hypertropia of 2 prism diopters, which increased to 4 diopters on left gaze. He also demonstrated 2 prism diopters upon head tilt to either side. There were also 6 prism diopters of exotropia noted. Extraocular movements showed mild limitation of supraduction in both eyes. A Maddox double rod test was normal. Anterior segments and fundoscopic examinations were negative. Four days later, he visited clinic again with resolution of diplopia. Blood testing for complete cell count, antinuclear antibody, and anti-AchR antibody was negative. A thyroid function test revealed mild elevation of T3 (205, normal range 82–179). MRI of the brain showed nonspecific changes over white matter.

References

  1. 1.
    Lepretre S, Graux C, Touzart A, Macintyre E, Boissel N. Adult T-type lymphoblastic lymphoma: treatment advances and prognostic indicators. Exp Hematol. 2017;51:7–16.CrossRefPubMedGoogle Scholar
  2. 2.
    Bassan R, Maino E, Cortelazzo S. Lymphoblastic lymphoma: an updated review on biology, diagnosis, and treatment. Eur J Haematol. 2016;96:447–60.CrossRefPubMedGoogle Scholar
  3. 3.
    Lin P, Jones D, Dorfman DM, Medeiros LJ. Precursor B-cell lymphoblastic lymphoma: a predominantly extranodal tumor with low propensity for leukemic involvement. Am J Surg Pathol. 2000;24:1480–90.CrossRefPubMedGoogle Scholar
  4. 4.
    Cortelazzo S, Ponzoni M, Ferreri AJ, Hoelzer D. Lymphoblastic lymphoma. Crit Rev Oncol Hematol. 2011;79(3):330–43.CrossRefPubMedGoogle Scholar
  5. 5.
    Sweetenham JW. Treatment of lymphoblastic lymphoma in adults. Oncology (Williston Park). 2009;23:1015–20.Google Scholar
  6. 6.
    Nakatomi H, Sasaki T, Kawamoto S, Fujimaki T, Furuya K, Kirino T. Primary cavernous sinus malignant lymphoma treated by gamma knife radiosurgery: case report and review of the literature. Surg Neurol. 1996;46(3):272–9.CrossRefPubMedGoogle Scholar
  7. 7.
    Delpassand ES, Kirkpatrick JB. Cavernous sinus syndrome as the presentation of malignant lymphoma: case report and review of the literature. Neurosurgery. 1988;23(4):501–4.CrossRefPubMedGoogle Scholar
  8. 8.
    Koh CS, Tan CT, Alhady SF. Cavernous sinus syndrome. A manifestation of non-Hodgkin’s lymphoma of the ethmoid sinus. Med J Aust. 1983;2(9):451–2.PubMedGoogle Scholar
  9. 9.
    Lee H, Choi KE, Park M, Lee SH, Baek S. Primary diffuse large B-cell non-Hodgkin lymphoma of the paranasal sinuses presenting as cavernous sinus syndrome. J Craniofac Surg. 2014;25(4):e338–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Sadruddin S, Medeiros LJ, DeMonte F. Primary T-cell lymphoblastic lymphoma of the cavernous sinus. J Neurosurg Pediatr. 2010;5(1):94–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Han MH, Chang KH, Kim IO, Kim DK, Han MC. Non-Hodgkin lymphoma of the central skull base: MR manifestations. J Comput Assist Tomogr. 1993;17:567–71.CrossRefPubMedGoogle Scholar
  12. 12.
    Demirkaya M, Sevinir B, Ozdemir O, Nazlioğlu HO, Okan M. Lymphoma of the cavernous sinus mimicking Tolosa-Hunt syndrome in a child. Pediatr Neurol. 2010;42(5):351–4.CrossRefPubMedGoogle Scholar
  13. 13.
    Fischbach FT, Dunning MB. A manual of laboratory and diagnostic tests. 7th ed. Philadelphia: Lippincott-Williams & Wilkins; 2004.Google Scholar
  14. 14.
    Burkhardt B, Reiter A, Landmann E, et al. Poor outcome for children and adolescents with progressive disease or relapse of lymphoblastic lymphoma: a report from the Berlin–Frankfurt–Muenster group. J Clin Oncol. 2009;27:3363–9.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • An-Guor Wang
    • 1
  1. 1.Department of OphthalmologyTaipei Veterans General Hospital, National Yang-Ming University School of Medicine, Yun-San Ophthalmology Education Research FoundationTaipeiTaiwan

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