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On further evaluation, his dysphagia was attributed to a vagus nerve palsy, and later during his admission, he developed rapidly progressing left facial and vestibulocochlear nerve palsies. Imaging studies displayed pathological enhancement of bilateral seventh and eighth cranial nerves, concerning for leptomeningeal recurrence of lymphoma. Cerebrospinal fluid analysis and flow cytometry were confirmatory, revealing markedly atypical monotypic CD19 positive B cells.<\/jats:p>","DOI":"10.1136\/bcr-2019-229988","type":"journal-article","created":{"date-parts":[[2019,7,20]],"date-time":"2019-07-20T06:24:08Z","timestamp":1563603848000},"page":"e229988","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Diffuse large B-cell lymphoma recurrence presenting as multiple, progressive cranial neuropathies"],"prefix":"10.1136","volume":"12","author":[{"given":"Abby R","family":"Goron","sequence":"first","affiliation":[{"name":"University of Maryland School of Medicine, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Devlin","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacy","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Maryland Baltimore, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,7,19]]},"reference":[{"key":"2025082801504196000_12.7.e229988.1","doi-asserted-by":"crossref","first-page":"447","DOI":"10.5581\/1516-8484.20120111","article-title":"Pathophysiology and molecular aspects of diffuse large B-cell lymphoma","volume":"34","author":"Gouveia","year":"2012","journal-title":"Rev Bras Hematol Hemoter"},{"key":"2025082801504196000_12.7.e229988.2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.05.012"},{"key":"2025082801504196000_12.7.e229988.3","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-009-9918-0"},{"key":"2025082801504196000_12.7.e229988.4","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2013.101741"},{"key":"2025082801504196000_12.7.e229988.5","doi-asserted-by":"publisher","DOI":"10.1023\/A:1005956925637"},{"key":"2025082801504196000_12.7.e229988.6","doi-asserted-by":"crossref","first-page":"319","DOI":"10.2174\/157339411797642597","article-title":"Leptomeningeal Metastasis: Challenges in Diagnosis and Treatment","volume":"7","author":"Leal","year":"2011","journal-title":"Curr Cancer Ther Rev"},{"issue":"6","key":"2025082801504196000_12.7.e229988.7","doi-asserted-by":"crossref","first-page":"E1150","DOI":"10.1227\/01.NEU.0000255475.98623.39","article-title":"Cerebellopontine angle cyst compressing the vagus nerve: case report","volume":"60","author":"Hayden","year":"2007","journal-title":"Neurosurgery"},{"key":"2025082801504196000_12.7.e229988.8","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1111\/j.1479-8077.2006.00204.x","article-title":"Cranial and peripheral neuropathy in rheumatoid arthritis with special emphasis to II, V, VII, VIII and XI cranial nerves","volume":"9","author":"Hamed","year":"2006","journal-title":"APLAR J Rheumatol"},{"key":"2025082801504196000_12.7.e229988.9","doi-asserted-by":"crossref","first-page":"265","DOI":"10.4103\/2152-7806.111304","article-title":"Carcinomatous meningitis: Leptomeningeal metastases in solid tumors","volume":"4","author":"Chamberlain","year":"2013","journal-title":"Surg Neurol Int"},{"key":"2025082801504196000_12.7.e229988.10","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.16.8021"},{"key":"2025082801504196000_12.7.e229988.11","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1525"},{"key":"2025082801504196000_12.7.e229988.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.diii.2013.06.013"},{"key":"2025082801504196000_12.7.e229988.13","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1212\/WNL.0000000000002838","article-title":"MR neurography of a vagal neuropathy","volume":"87","author":"Ventura","year":"2016","journal-title":"Neurology"},{"key":"2025082801504196000_12.7.e229988.14","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000261909.28915.83"},{"key":"2025082801504196000_12.7.e229988.15","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-009-0057-4"},{"key":"2025082801504196000_12.7.e229988.16","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-010-1104-0"},{"key":"2025082801504196000_12.7.e229988.17","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1007\/s12094-007-0086-4","article-title":"Primary central nervous system lymphoma treated with rituximab plus temozolomide in a second line schedule","volume":"9","author":"Santisteban","year":"2007","journal-title":"Clin Transl Oncol"},{"key":"2025082801504196000_12.7.e229988.18","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.04.1518"},{"key":"2025082801504196000_12.7.e229988.19","doi-asserted-by":"crossref","unstructured":"Katyal N , Wadhwa A , Bollu PC . 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Isolated Abducens Nerve Palsy Secondary to Central Nervous System Infiltration of Diffuse Large B-Cell Lymphoma. 2014. 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