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Rare clinical presentation of diffuse large B-cell lymphoma as otitis media and facial palsy.

Siddiahgari SR, Yerukula P, Lingappa L, Moodahadu LS - J Pediatr Neurosci (2016 Jan-Mar)

Bottom Line: Extra nodal presentation of Non Hodgkins Lymphoma (NHL) is a rare entity, and data available about the NHL that primarily involves of middle ear and mastoid is limited.We report a case of diffuse large B cell lymphoma (DLBCL), in a 2 year 8 month old boy, who developed otalgia and facial palsy.This case highlights the importance of considering malignant lymphoma as one of the differential diagnosis in persistent otitis media and/facial palsy.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Hematooncology, Rainbow Children's Tertiary Care Centre, Hyderabad, Telangana, India.

ABSTRACT
Extra nodal presentation of Non Hodgkins Lymphoma (NHL) is a rare entity, and data available about the NHL that primarily involves of middle ear and mastoid is limited. We report a case of diffuse large B cell lymphoma (DLBCL), in a 2 year 8 month old boy, who developed otalgia and facial palsy. Computed tomography revealed a mass in the left mastoid. Mastoid exploration and histopathological examination revealed DLBCL. This case highlights the importance of considering malignant lymphoma as one of the differential diagnosis in persistent otitis media and/facial palsy.

No MeSH data available.


Related in: MedlinePlus

Computed tomography head and neck of right side showing no abnormality
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Figure 2: Computed tomography head and neck of right side showing no abnormality

Mentions: A 2 years 8 months old boy visited our Tertiary Care Hospital with complaints of ear ache (left side) and left facial palsy of 4 weeks duration. After initial 2 weeks of these symptoms, there was whitish serous discharge from the left ear. Before referral to our hospital, he was treated for otitis media with antibiotics, details of which were not available. His complete blood picture and biochemistry investigations done in our hospital were within normal limits. As the symptoms persisted for 4 weeks, computed tomography of head and neck was done which was suggestive of solid mass lesion of 2 cm × 2 cm size in the left mastoid with destruction of mastoid bone [Figure 1]. No abnormality was seen on the right side [Figure 2]. Suspecting chronic otitis media with cholesteatoma, left mastoidectomy was performed. A mass was found in the middle ear extending into the mastoid. The disease was in stage 1 (as per Murphy's staging) and was completely resected. Histopathological examination showed large cells of lymphoid cell proliferation immune histochemistry was positive for CD20, Bcl-2 and negative for CD3, with low MIB-1, which confirmed DLBCL. His positron emission tomography for staging, bone marrow and cerebrospinal fluid revealed no abnormality.


Rare clinical presentation of diffuse large B-cell lymphoma as otitis media and facial palsy.

Siddiahgari SR, Yerukula P, Lingappa L, Moodahadu LS - J Pediatr Neurosci (2016 Jan-Mar)

Computed tomography head and neck of right side showing no abnormality
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4862291&req=5

Figure 2: Computed tomography head and neck of right side showing no abnormality
Mentions: A 2 years 8 months old boy visited our Tertiary Care Hospital with complaints of ear ache (left side) and left facial palsy of 4 weeks duration. After initial 2 weeks of these symptoms, there was whitish serous discharge from the left ear. Before referral to our hospital, he was treated for otitis media with antibiotics, details of which were not available. His complete blood picture and biochemistry investigations done in our hospital were within normal limits. As the symptoms persisted for 4 weeks, computed tomography of head and neck was done which was suggestive of solid mass lesion of 2 cm × 2 cm size in the left mastoid with destruction of mastoid bone [Figure 1]. No abnormality was seen on the right side [Figure 2]. Suspecting chronic otitis media with cholesteatoma, left mastoidectomy was performed. A mass was found in the middle ear extending into the mastoid. The disease was in stage 1 (as per Murphy's staging) and was completely resected. Histopathological examination showed large cells of lymphoid cell proliferation immune histochemistry was positive for CD20, Bcl-2 and negative for CD3, with low MIB-1, which confirmed DLBCL. His positron emission tomography for staging, bone marrow and cerebrospinal fluid revealed no abnormality.

Bottom Line: Extra nodal presentation of Non Hodgkins Lymphoma (NHL) is a rare entity, and data available about the NHL that primarily involves of middle ear and mastoid is limited.We report a case of diffuse large B cell lymphoma (DLBCL), in a 2 year 8 month old boy, who developed otalgia and facial palsy.This case highlights the importance of considering malignant lymphoma as one of the differential diagnosis in persistent otitis media and/facial palsy.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Hematooncology, Rainbow Children's Tertiary Care Centre, Hyderabad, Telangana, India.

ABSTRACT
Extra nodal presentation of Non Hodgkins Lymphoma (NHL) is a rare entity, and data available about the NHL that primarily involves of middle ear and mastoid is limited. We report a case of diffuse large B cell lymphoma (DLBCL), in a 2 year 8 month old boy, who developed otalgia and facial palsy. Computed tomography revealed a mass in the left mastoid. Mastoid exploration and histopathological examination revealed DLBCL. This case highlights the importance of considering malignant lymphoma as one of the differential diagnosis in persistent otitis media and/facial palsy.

No MeSH data available.


Related in: MedlinePlus