Asymmetrical and Isolated Hypoglossal Nerve Palsy Accompanied by a New Subset of Anti-ganglioside Antibodies in a Patient with Diffuse Large B Cell Lymphoma

Intern Med. 2019 Jan 15;58(2):283-286. doi: 10.2169/internalmedicine.1269-18. Epub 2018 Aug 24.

Abstract

Malignant lymphoma sometimes involves peripheral nerves due to paraneoplastic syndrome associated with anti-ganglioside antibodies. We report a very rare case of malignant lymphoma accompanied by an asymmetrical and isolated hypoglossal nerve palsy associated with a new subset of anti-ganglioside antibodies. Magnetic resonance imaging and 18F-2-deoxy-2-fluoro-D-glucose position emission tomography showed no abnormalities of the hypoglossal nerve nucleus; however, the patient' s serum was positive for anti-sulfated glucuronyl paragloboside IgM antibodies as well as anti-GM1 IgM and anti-GQ1b IgM antibodies. The present case might suggest a paraneoplastic asymmetrical and isolated hypoglossal nerve palsy associated with a new subset of anti-ganglioside antibodies.

Keywords: anti-ganglioside antibody; hypoglossal nerve palsy; malignant lymphoma; paraneoplastic syndrome.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Fluorodeoxyglucose F18
  • G(M1) Ganglioside / immunology*
  • Globosides / immunology*
  • Humans
  • Hypoglossal Nerve Diseases / diagnostic imaging
  • Hypoglossal Nerve Diseases / etiology*
  • Hypoglossal Nerve Diseases / immunology
  • Immunoglobulin M / blood*
  • Lymphoma, Large B-Cell, Diffuse / complications*
  • Lymphoma, Large B-Cell, Diffuse / diagnostic imaging
  • Lymphoma, Large B-Cell, Diffuse / immunology*
  • Magnetic Resonance Imaging
  • Male
  • Positron Emission Tomography Computed Tomography
  • Radiopharmaceuticals
  • Tomography, X-Ray Computed

Substances

  • Globosides
  • Immunoglobulin M
  • Radiopharmaceuticals
  • sulfate-3-glucuronyl paragloboside
  • Fluorodeoxyglucose F18
  • G(M1) Ganglioside