A case report of secondary neurolymphomatosis showing selective nerve infiltration and massive lumbar plexus enlargement
| Autor: | Keisuke Suzuki, Hiroki Onuma, Wataru Takahashi, Hadzki Matsuda, Norito Kokubun, Kinuko Mitani, Mai Hamaguchi, Reika Aoki |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Nervous system Pathology medicine.medical_specialty Lumbosacral Plexus Case Report Neurolymphomatosis Nerve biopsy Cauda equina 03 medical and health sciences Fatal Outcome 0302 clinical medicine immune system diseases hemic and lymphatic diseases medicine Humans Spinal canal RC346-429 Aged Lumbar plexus medicine.diagnostic_test business.industry Malignant lymphoma Nervous tissue General Medicine Spinal cord Magnetic Resonance Imaging 030104 developmental biology medicine.anatomical_structure Peripheral nervous system Neuralgia Female Lymphoma Large B-Cell Diffuse Neurology. Diseases of the nervous system Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | BMC Neurology, Vol 21, Iss 1, Pp 1-5 (2021) BMC Neurology |
| ISSN: | 1471-2377 |
| DOI: | 10.1186/s12883-021-02330-5 |
| Popis: | Background Neurolymphomatosis (NL) is a rare manifestation of malignant lymphoma that shows selective infiltration to the peripheral nervous system primarily or secondarily. We report a patient with secondary NL caused by germinal center B-cell (GCB)-type diffuse large B-cell lymphoma (DLBCL) who showed selective infiltration of the lumbar plexus to the spinal cord and massive nerve enlargement resulting in severe pain. Case presentation A 72-year-old female exhibited asymmetric motor and sensory impairments and pain in the lower limbs that progressed for five months. Magnetic resonance imaging (MRI) showed an enlarged lumbar plexus, which continued to the cauda equina via the L3 and L4 spinal nerves. Her symptoms gradually worsened. Ten months after the onset of symptoms, the enlarged cauda equina filled the spinal canal space, and the spinal cord was swollen. A cauda equina biopsy was performed, and she was diagnosed with GCB-type DLBCL with CD10 positivity. The primary tumor was found in a mammary cyst. The autopsy study did not show apparent infiltration, except in the nervous system. Conclusions Although there are many neurologic phenotypes of malignant lymphoma, the association between the cytological characteristics of lymphoma and the neurological phenotypes is still unclear. Several reports of CD10-positive secondary NL are available, whereas peripheral or central nervous tissue origin lymphoma cases are mostly negative for CD10. CD10 staining may be useful for distinguishing primary NL from secondary NL. NL often has a strong organotropism for peripheral nervous tissue, which makes early diagnosis challenging. |
| Databáze: | OpenAIRE |
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