A Case of Malignant Sphenoid Sinus Lymphoma with Abducens Nerve Palsy

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  • 外転神経麻痺で発症した蝶形骨洞悪性リンパ腫例
  • ガイテンシンケイ マヒ デ ハッショウ シタ チョウケイコツドウ アクセイ リンパ シュレイ

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Abstract

A 73-year-old woman reporting left-eye pain, left proptosis, left abducens palsy with diplopia, headache and nausea while being treated for chronic sinusitis was found to have signs of sphenoiditis and ethmoiditis in computed tomography (CT) and magnetic resonance imaging (MRI). We conducted endoscopic sinus surgery on suspicion of orbital apex syndrome due to chronic sinusitis, finding the left sphenoid sinus to be filled with yellowish-white caseous tissue underlaid with abnormal pathologycal mucosa. Pathological examination of abnormal tissue yielded a diagnosis of diffuse large B-cell lymphoma. The lesion was considered the primary one after systemic imaging showed no other lesion. Complete remission was obtained after 6 courses of rituximab THP-COP.<br> A primary malignant lymphoma sphenoid sinus lesion is very rare.<br>

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