Cancer Res Treat.  2011 Jun;43(2):134-138.

Numb Chin Syndrome with Concomitant Painful Ophthalmoplegia Leading to a Diagnosis of Diffuse Large B Cell Lymphoma

• Kim YI
• An JY
• Lee KS
• Sung HY
• Hong YS
• Kang WK
• Jung CK
• Kim JS

Abstract

Painful ophthalmoplegia (PO) and concomitant numb chin syndrome (NCS) is a very rare event. There are a few reports in the literature about PO and concomitant NCS that have preceded the diagnosis of a malignancy. In this report, we describe a patient with diffuse large B cell lymphoma who presented with PO and concomitant NCS as the initial symptom of the disease.

Keyword

Painful ophthalmoplegia; Numb chin syndrome; Lymphoma

MeSH Terms

Chin
Humans
Lymphoma
Lymphoma, B-Cell
Ophthalmoplegia

Figure

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  Fig. 1 Contrast-enhanced T1-weighted coronal and axial magnetic resonance images of the brain show a slightly enhanced mass lesion in the left cavernous sinus (white arrows).

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  Fig. 2 18F-fluorodeoxyglucose (FDG) positron emission tomography shows intense FDG uptake in an extensive number of sites, including the abdominopelvic organs (small and large intestines [predominantly the ascending colon and rectum], peritoneum, omentum, mesentery, and the left adrenal gland), the skeletal system (maxilla, mandible, vertebrae, sternum, ribs, clavicles, scapulae, pelvic bones, humeri, and femurs), the left pleura, the bilateral skull base, and the left cavernous sinus.

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  Fig. 3 (A) Tumor cells diffusely infiltrate the intestinal wall and are large lymphoid cells with oval to round, vesicular nuclei and scanty cytoplasm (H&E, ×400). (B) In addition, theses tumor cells were strongly reactive for a B-cell marker, CD20 (×400). (C) Ki-67 immunostaining revealed a high proliferation index (ki-67=90%).

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