Diplopia as an initial manifestation of disseminated non-hodgkin's lymphoma.
A 37-year-old male presented a sudden diplopia. Ocular examination showed a partial paresis of the left eye (LE) on the left gaze, progressing in a few days towards a total ophthalmoplegia. Further investigation revealed an intra-orbital mass, immunohistologically diagnosed as a Diffuse Large B-cell Lymphoma (DLBCL), according to the WHO classification. Since the patient was in an advanced, disseminated stage of the disease (IVA-E), treatment was based on systemic and intrathecal chemotherapy with a pancranial radiotherapy. The clinical course was poor with only a 10-month survival. We wish to stress that the possibility of orbital malignancy in young adults with acute onset of ophthalmoplegia should be included in the differential diagnosis.
Claeys
A
A
Department of Ophthalmology, Academisch Ziekenhuis, Vrije Universiteit Brussel. anne.claeys@az.vub.ac.be
Trullemans
F
F
Maes
J
J
Hennekes
R
R
Salu
P
P
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D001980:Bronchi / Q000473:pathology; D001999:Bronchoscopy; D004172:Diplopia / Q000209:etiology*; D017809:Fatal Outcome; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D009901:Optic Nerve Diseases / Q000000981:diagnostic imaging*; D009918:Orbital Neoplasms / Q000000981:diagnostic imaging*; D010190:Pancreatic Neoplasms / Q000473:pathology; D018714:Radiotherapy, Adjuvant; D014057:Tomography, X-Ray Computed