Partial Oculomotor Nerve Palsy as the First Presentation of Extranodal Natural Killer/T-Cell Lymphoma
Bibliographic record
Abstract
Extranodal natural killer/T-cell lymphoma (ENKTL) is a rare and aggressive subtype of non-Hodgkin lymphoma, typically involving the nasal cavity. However, it can occasionally present in extranodal sites without nasal involvement, complicating diagnosis. This report describes a 78-year-old man who presented with progressive double vision and visual loss in the right eye over 3 weeks. Examination revealed partial oculomotor nerve palsy with pupillary involvement and signs of optic neuropathy, leading to a diagnosis of orbital apex syndrome. The nasopharyngeal evaluation showed no nasal lesions. Magnetic resonance imaging (MRI) identified diffuse enhancement of the extraocular muscles, intraorbital soft tissues, and optic nerve sheath in the right orbit. A right medial rectus muscle biopsy confirmed extranodal NK/T-cell lymphoma through immunohistochemical analysis. Chemotherapy was initiated, significantly improving both ophthalmoplegia and visual acuity. This case underscores the importance of comprehensive neuro-ophthalmic evaluation and biopsy for diagnosing ENKTL, especially in atypical presentations without nasal involvement. Early detection and treatment are critical for achieving favorable outcomes in this rare disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".