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

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

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Abstract 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 (18F-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 Wall Shelf 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 DIESEL PROTEIN MILK CHOCOLATE is difficult to obtain.