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Abstract
Neuropathies can occur in patients with diffuse large B-cell lymphoma (DLBCL) at any stage of the disease as a presenting symptom or during later stages of illness. A wide spectrum of neurological association is known to occur with DLBCL, ranging from cranial nerve palsies to peripheral neuropathies. Evaluation of cranial and peripheral neuropathies in patients with DLBCL requires meticulous clinical, imaging, and electrodiagnostic testing. A 75-year-old right-handed female with a known history of multiple cranial neuropathies and DLBCL presented with acute dysphagia and upper extremity weakness of one-week duration. On evaluation, she was found to have right vagal nerve palsy. Cerebrospinal fluid (CSF) analysis along with flow cytometry testing showed CD19 and CD20 positive B cells, confirming neoplastic infiltration of CSF. We describe the case and review the literature of the association of cranial nerve palsies with DLBCL.
Highlights
Cranial nerve palsies occur infrequently in patients with diffuse large B-cell lymphoma (DLBCL) and are seen in only 5% of the DLBCL cases [1]
We describe a patient who presented with acute dysphagia and upper extremity weakness having been diagnosed with sixth and seventh cranial nerve palsies just two weeks prior
A 75-year-old right-handed female was brought to the emergency department (ED) with complaints of dysphagia, increasing fatigue, upper extremity weakness more prominent on the left side, and upper extremity numbness for a one-week duration
Summary
Cranial nerve palsies occur infrequently in patients with diffuse large B-cell lymphoma (DLBCL) and are seen in only 5% of the DLBCL cases [1]. We describe a patient who presented with acute dysphagia and upper extremity weakness having been diagnosed with sixth and seventh cranial nerve palsies just two weeks prior She had a known history of DLBCL and was receiving chemotherapy at the time of presentation. A 75-year-old right-handed female was brought to the emergency department (ED) with complaints of dysphagia, increasing fatigue, upper extremity weakness more prominent on the left side, and upper extremity numbness for a one-week duration She had a history of B-cell lymphoma and had received six cycles of chemotherapy (CHOP). Her other medical comorbidities were congestive heart failure (ejection fraction
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