Cerebral B-cell lymphoma following treatment for Tolosa-Hunt syndrome.
We herein report a unique case of cerebral lymphoma which occurred after lymphocytic neuritis of cranial nerves causing Tolosa-Hunt syndrome and demonstrate the histological difference between these two diseases. A 70-year-old woman developed a sensory disturbance in the first and third divisions of the left trigeminal nerve and a left ocular movement disturbance five years before death. Although she was clinically diagnosed to have a schwannoma in the left cavernous sinus, a histologic examination verified a diffuse infiltration of T lymphocytes in the left trigeminal ganglion. Corticosteroid therapy was effective. Thereafter she demonstrated a disturbance of consciousness and dysphasia four years after surgery. A T1-weighted magnetic resonance image (MRI) disclosed high intensity lesions in both the basal ganglia and corpus callosum. She also showed progressive spastic paralysis. At autopsy a diagnosis of primary intracranial B-cell lymphoma was made. Although there was no invasion of the lymphoma cells into the left trigeminal nerves, a mild inflammatory infiltration of T cells still remained.
Takao
T
T
Department of Neuropathology, Neurological Institute, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Kaku
S
S
Tashima
T
T
Iwaki
T
T
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy; D003345:Corticosterone / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000473:pathology*; D009886:Ophthalmoplegia / Q000473:pathology / Q000628:therapy*
D000893:Anti-Inflammatory Agents; D003345:Corticosterone