Extrapulmonary lymphomatoid granulomatosis presenting as Pancoast's syndrome

Area of Science:

• Oncology
• Neurology
• Pathology

Background:

• Pancoast's syndrome, characterized by specific neurological deficits and a supraclavicular mass, can have various underlying causes.
• Lymphomatoid granulomatosis is a rare systemic vasculitis with a propensity for extranodal involvement, including neurological complications.

Observation:

• A 55-year-old male presented with symptoms consistent with Pancoast's syndrome, including left-sided Horner's syndrome, a supraclavicular mass, and significant left arm weakness and wasting due to brachial plexus involvement.
• Histopathological examination of the mass revealed lymphomatoid granulomatosis.

Findings:

• Neurological presentation is an uncommon initial manifestation of lymphomatoid granulomatosis.
• The patient's constellation of symptoms, including Pancoast's syndrome and brachial plexus lesion, was attributed to lymphomatoid granulomatosis.

Implications:

• Lymphomatoid granulomatosis should be included in the differential diagnosis for patients presenting with Pancoast's syndrome, especially when accompanied by neurological deficits.
• Early consideration of this rare condition may lead to timely diagnosis and treatment, potentially improving patient outcomes.