Bing-Neel Syndrome revisited
Florian Fintelmann1, Reza Forghani, Pamela W Schaefer
1Department of Radiology, Massachusetts General Hospital, Boston MA 02114, USA.
Clinical Lymphoma & Myeloma
|April 14, 2009
Summary
Bing-Neel Syndrome, a neurological complication of Waldenström macroglobulinemia (WM), can involve direct CNS infiltration by malignant cells or non-cellular mechanisms like IgM deposition.
Area of Science:
- Neurology
- Hematology
- Oncology
Background:
- The Bing-Neel Syndrome (BNS) describes neurological symptoms in patients with Waldenström macroglobulinemia (WM).
- Previous literature lacks clear classification of central nervous system (CNS) manifestations in WM.
Purpose of the Study:
- To clarify the spectrum of CNS involvement in WM.
- To categorize WM-CNS based on underlying pathology.
Main Methods:
- Comprehensive literature search from 1936 to 2008 for "Bing-Neel Syndrome" and "WM affecting the CNS" (WM-CNS).
- Exclusion criteria included hyperviscosity, malignant transformation, vasculitis, and ophthalmologic symptoms.
- Analysis of clinical symptoms, cerebrospinal fluid (CSF), imaging, and histopathology.
Main Results:
- Identified two distinct forms of WM-CNS.
- Form 1: Direct infiltration of the CNS by lymphoplasmacytoid cells.
- Form 2: Non-cellular pathology, potentially involving IgM deposition.
Conclusions:
- WM-CNS can arise from direct cellular infiltration or indirect mechanisms.
- This classification aids in understanding and diagnosing neurological complications of WM.
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