Fatal peripheral neurolymphomatosis after remission of histiocytic lymphoma

Shoenfeld, Yehuda; Aderka, Dan; Sandbank, U.; Gadot, N.; Santo, Mario; Pinkhas, J

doi:10.1212/wnl.33.2.243

Cited by 37 publications

(25 citation statements)

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“…Although the parenchyma of the brain and spinal cord has been spared in some patients with neurolymphomatosis, the meninges have usually been involved [5,6]. This patient was a very rare case of B-cell neurolymphomatosis with lymphomatous infiltration confined to the PNS, although involvement limited to the PNS has been confirmed in a few autopsy cases with histiocytic lymphoma, adult T-cell leukemia, or chronic lymphatic leukemia [7][8][9]. The possibility cannot be excluded that lymphoma cells in the CNS disappeared after generalized or intrathecal chemotherapy in our patient.…”

Section: Discussionmentioning

confidence: 78%

B-cell neurolymphomatosis confined to the peripheral nervous system

Shibata-Hamaguchi¹,

Samuraki²,

Furui³

et al. 2007

Journal of the Neurological Sciences

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Section: Discussionmentioning

confidence: 78%

B-cell neurolymphomatosis confined to the peripheral nervous system

Shibata-Hamaguchi¹,

Samuraki²,

Furui³

et al. 2007

Journal of the Neurological Sciences

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“…6,23 Less commonly, they may present with a diffuse, progressive, and subacute or chronic peripheral neuropathy resembling GBS or CIDP. 9,117 Hodgkin's Lymphoma. HL is less likely than NHL to infiltrate peripheral nerves, or present as a mass lesion, and more likely to cause autoimmune disorders due to the underlying immune system disturbance.…”

Section: Neurological Syndromes In Individual Lymphomasmentioning

confidence: 99%

“…132 Polyneuropathy. Polyneuropathy can be caused by diffuse nerve infiltration 120 by NHL or NL which may mimic CIDP, 117 autoimmune neuropathies such a CIDP or GBS, 121 vasculitis, or cryoglobulinemia. 132 The history helps to determine whether the process had an asymmetrical onset which suggests either nerve infiltration or a vasculitis.…”

Section: Clinical Presentationsmentioning

confidence: 99%

“…In addition, peripheral nerve and central nervous system infiltration can occur while the lymphoma is in remission, presumably due to the sanctuary effect from chemotherapy drugs created by the bloodnerve barrier. 28,117,142 Unless MRI neurography is unequivocal, nerve biopsy should be performed with immunolabeling studies. 73,121,124,132,137 Despite this, many patients are diagnosed at autopsy, 5 suggesting that clinicians should adopt a more aggressive approach to these patients.…”

Section: Clinical Presentationsmentioning

confidence: 99%

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Lymphoma and peripheral neuropathy: A clinical review

2004

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Lymphoma occasionally affects the peripheral nervous system. When it does, the diagnosis can be elusive since many patients present without known lymphoma. Most peripheral nerve complications are due to non-Hodgkin's lymphoma (NHL), which infiltrates nerves causing axonal damage. This disorder can affect nerve roots and cranial nerves, often associated with lymphomatous meningitis. NHL may also infiltrate peripheral nerves and cause plexopathy, mononeuropathy, or generalized neuropathy. These neuropathies may resemble an asymmetric mononeuropathy multiplex or a generalized disorder such as chronic inflammatory demyelinating polyradiculoneuropathy. When NHL infiltrates diffusely, the term neurolymphomatosis is used. Hodgkin's lymphoma (HL), by contrast, rarely infiltrates nerves. More often, HL causes immunological disorders of the peripheral nervous system such as inflammatory plexopathy or Guillain-Barré syndrome. Other rare lymphomas such as intravascular lymphoma and Waldenstrom's macroglobulinemia can also affect peripheral nerves in specific ways. In addition, other malignant and nonmalignant lymphoproliferative disorders enter into the differential diagnosis of lymphomatous neuropathy. This review discusses the multiple peripheral nerve presentations of lymphoma from the clinician's point of view and provides a guide to the evaluation and diagnosis of these uncommon, challenging disorders.

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“…Recurrence in multiple peripheral nerves may be accompanied by CNS involvement, 29,30,49 and this phenomenon suggests that the blood-nerve barrier may protect tumor cells from chemotherapeutic agents. 57 Recurrence in a single peripheral nerve is rare, with only three cases reported in the English literature 31,56,57 ; one of the cases 56 was a relapse of a primary brain lymphoma.…”

mentioning

confidence: 99%

Primary Lymphoma of Peripheral Nerve

Misdraji

Ino

Louis

et al. 2000

The American Journal of Surgical Pathology

108

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Lymphoma presenting as a solitary tumor of peripheral nerve is exceedingly rare, with only six previously reported cases. The authors describe an additional four cases of primary lymphoma of peripheral nerve involving the sciatic nerve (two cases), the radial nerve, and the sympathetic chain and spinal nerve. The patients were two men and two women with an average age of 55.5 years. All tumors were high-grade B-cell lymphomas. Two patients experienced relapse of disease with involvement of other nervous system sites and died of lymphoma. One patient is alive with stable local disease at 57 months. The fourth patient is alive with no evidence of disease at 54 months. Expression of neural cell adhesion molecule (CD56) has been reported to correlate with an increased incidence of central nervous system involvement in peripheral T-cell lymphoma; all their cases were CD56 negative. Recent reports indicate a high proportion of primary brain lymphomas show loss of CDKN2A/p16 gene expression. Therefore, CDKN2A/p16 was evaluated in their patients both by polymerase chain reaction and by immunohistochemistry for the p16 protein. The authors found homozygous deletion of the CDKN2A/p16 gene in one of three patients studied, confirmed immunohistochemically by absent staining for p16. The fourth patient showed absent staining for p16, suggesting inactivation of the gene in this case as well. The two patients with p16 loss both died of lymphoma, whereas the two patients with normal p16 expression are alive. Primary lymphoma of peripheral nerve is a rare neoplasm, usually of large B-cell type, has a variable prognosis, and appears to have less consistent loss of p16 expression than primary central nervous system lymphoma.

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Fatal peripheral neurolymphomatosis after remission of histiocytic lymphoma

Cited by 37 publications

References 0 publications

B-cell neurolymphomatosis confined to the peripheral nervous system

B-cell neurolymphomatosis confined to the peripheral nervous system

Lymphoma and peripheral neuropathy: A clinical review

Primary Lymphoma of Peripheral Nerve

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