[Paraneoplastic encephalomyelitis]

A case of parancoplastic encephalomyelitis detected in a 60 year old man with clinical signs of a polyradiculitis and anterior horn lesion is reported. Death occurred after 5 months due to cardiorespiratory insufficiency. On autopsy, an occult small cell carcinoma of the lung with metastases in the regional lymph nodes was found. The neuropathological examination revealed a polioencephalomelitis which primarily involved the limbic cortex, brain stem, spinal cord and posterior root ganglia. No virus material could be detected with immunhistochemical methods and in situ hybridisation. The inflammatory infiltrate was mainly composed of T-cells and to a lesser extent B-cells and mature macrophages. Literature and hypotheses concerning pathogenesis are reviewed.