Recurrent Diffuse Large B-Cell Lymphoma Presenting with Pancoast Syndrome: A Rare Cause of Radicular Neck Pain in the Emergency Department

Publication date: Available online 23 July 2018

Source: The Journal of Emergency Medicine

Author(s): Matthew S. Correia, Richard F. Clark

Abstract

Background

Pancoast syndrome is an uncommon complication of apical lung tumors. Symptoms include pain, brachial plexopathy, and Horner's syndrome, and are the result of extrinsic compression of tissues within the thoracic inlet. Lymphoma is a very rare etiology.

Case Report

We describe the presentation of a 59-year-old male with recurrent diffuse large B-cell lymphoma presenting with Pancoast syndrome.

Why Should an Emergency Physician Be Aware of This?

Cancer is an uncommon cause of radicular neck pain but should be considered in the differential, particularly when constitutional complaints are also present. Symptoms and physical examination findings associated with Pancoast syndrome are the consequence of compression of the C7–T2 vertebral roots and sympathetic chain. Computed tomography is usually required to definitively visualize the mass.

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