Reticulosis of the Nervous System Simulating Acute Infective Polyneuritis

Lymphoma-associated dysimmune polyneuropathies

“…Pathological study of peripheral nerves confirmed acquired IDP (with/without secondary axonal injury) at autopsy in 4 patients [70,72,75,76,88] and on biopsy in 5 patients [75,76,81,84,93]. Such study is important because lymphomatous nerve/root infiltration may mimic GBS [5,104,105] i.e., there exists a risk of GBS misdiagnosis.…”

“…Specifically, this review concentrates on lymphoma and more-or-less well-defined immune neuropathy subgroups that are caused by humoral and/or cell-mediated immune attacks against either known or undetermined peripheral nerve antigens. The selective approach to this topic entailed careful screening of the literature and the exclusion of reports with variables that interfered with the interpretation of chosen, defined neuropathy subgroups: (a) cryoglobulinemic neuropathy (mechanism is vasculitic ischemic damage to nerves); (b) plasma cell dyscrasias that are not usually classified with the lymphomas [1] e.g., Waldenström's macroglobulinemia/IgM-secreting lymphoplasmacytic lymphoma (although deposits of endoneurial monoclonal IgM secreted by plasma cells may lead to immune-mediated neuropathy) [11][12][13]; (c) "paraneoplastic" primarily sensory [14][15][16] or motor [17][18][19] neuronopathies (immune attack presumably directed at nerve cell body antigens); (d) initial presentation as, or exacerbation of, an acquired inflammatory demyelinating neuropathy but: (1) biological treatment likely contributed significantly to immune dysregulation e.g., rituximab introduction [20] or maintenance therapy [21], or recent completion of a course of alemtuzumab [22]; (2) effects of therapy resulted in severe superimposed immune disturbance e.g., acute tumor lysis syndrome [23], mobilization therapy with "pyrexia of unknown origin" [24], or after autologous bone marrow transplantation [25,26]; (3) preceded by virus infection/reactivation e.g., Varicella zoster reactivation [27], or (4) eventual evidence was found of malignant lymphocytic spread to CSF/nerve roots [28][29][30] or peripheral nerves [31]. A systematic search was conducted of relevant publications using databases such as MEDLINE [PubMed], EMBASE and DynaMed, and included case reports and series, retrospective studies, and reviews.…”

Lymphoma and peripheral neuropathy: A clinical review

“…These disorders are more commonly reported with HL than NHL. 82,140 Since infiltrative lymphoma can mimic dysimmune neuropathies, 1,32 however, nerve biopsy with immunotyping is essential to diagnosis in most cases. 74,140 In some cases, antibodies likely derived from molecular mimicry of antigens in lymphoma cells or accompanying viral infections may attack similar antigens in nerve cells.…”

“…24,62 With more diffuse infiltration, a GBS-or CIDP-like syndrome may occur, with some findings on electromyography and nerve conduction studies (EMG) suggesting demyelination. 1,16,101,141 Due to immunological disturbances, some of these patients may develop a true autoimmune neuropathy syndrome such as CIDP or other disorders associated with specific antinerve antibodies. 12,82,85,155 NHL can also cause a distal, predominantly axonal neuropathy during the late stages of advanced disease.…”

Involvement of the nervous system in malignant lymphoma in Nigeria.

“…Lesions in the central nervous system were found in North American cases of malignant lymphoma resembling the African variety (Dorfman, 1965). The lesions in both the African and North American cases are like those known to occur in lymphomas in general, and particularly in lymphosarcoma (Allison and Gordon, 1955;Browder and de Veer, 1939;Burstein, Kernohan and Uihlein, 1963;Critchley and Greenfield, 1930;Gordon, 1957;Hutchinson et al, 1958;Moore et al, 1960;Russell and Rubinstein, 1963;Sparling, Adams and Parker, 1947;Whisnant, Sickert and Sayre, 1956;and Williams et al, 1951).…”