Primary B-cell lymphoma of the clivus: Case report
Section snippets
Case report
A 60-year-old woman with persistent headaches for 2 months presented to the Emergency Department complaining of sudden onset of double vision while driving. The visual defect initially occurred only on left lateral gaze, but rapidly progressed to a constant state. Covering one eye relieved the patient’s visual symptoms. The headaches had been treated with antibiotics because a computed tomography (CT) scan showed possible sphenoid sinusitis. Medical history included a functional endoscopic
Discussion
Diffuse large B-cell lymphoma may occur at any age, but the peak incidence is in the 60s. Patients often present with a rapidly enlarging symptomatic mass at a single node or at an extranodal site. Common sites in the head and neck include Waldeyers ring, salivary glands, nasal cavity, paranasal sinuses, thyroid gland, and orbit [14]. Involvement of the bone marrow is usually late in the course of the disease.
If left untreated, diffuse B-cell lymphomas are rapidly fatal because of their
Conclusion
Diffuse large B-cell lymphoma of the clivus is an uncommon condition, and the primary clival location of the lymphoma without any other nodal site is also rare. An endoscopic transsphenoidal approach to the skull base is described along with characteristic clinical, radiologic, and pathologic findings of the lesions. When patients present with persistent headaches and diplopia, space-occupying lesions of the sella should be considered.
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