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[Systemic neurolymphomatosis complicated in diffuse large B-cell lymphoma].
Takayoshi Tachibana1, Naoto Tomita, Tomomi Ueda
1Department of Hematology, Shizuoka Red Cross Hospital.
[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology
|January 22, 2008
Summary
A rare case of uterine diffuse large B-cell lymphoma spread to the central nervous system and peripheral nerves, causing neurological deficits. Autopsy revealed systemic neurolymphomatosis, highlighting a challenging diagnostic and treatment scenario.
Area of Science:
- Neurology
- Oncology
- Pathology
Background:
- A 73-year-old woman presented with Stage IVB uterine diffuse large B-cell lymphoma.
- Initial treatment involved cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) therapy.
Observation:
- Following chemotherapy, the patient developed right abducens nerve paralysis, indicative of central nervous system lymphoma infiltration.
- Subacute onset of asymmetric numbness and weakness in all four limbs, diagnosed as mononeuritis multiplex via nerve conduction studies.
Findings:
- Despite chemotherapy with methotrexate and other treatments, neurological symptoms progressed.
- Autopsy revealed systemic neurolymphomatosis, confirming widespread peripheral nerve involvement by lymphoma cells.
Implications:
- This case underscores the potential for diffuse large B-cell lymphoma to manifest as neurolymphomatosis.
- Highlights the diagnostic challenges and limited treatment efficacy in advanced stages with widespread neurological infiltration.
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