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Published on: May 26, 2023
Primary neurolymphomatosis diagnosis and treatment: a retrospective study
S Lagarde1, E Tabouret1, M Matta1
1Service de Neuro-Oncologie, CHU La Timone, Assistance publique-Hôpitaux de Marseille, 264, rue St-Pierre, 13005 Marseille, France.
Background:
To discuss the therapeutic approach for primary neurolymphomatosis.
Methods:
We report all primary neurolymphomatosis cases referred to our institution, with descriptions of clinical, radiological, electrophysiological, histological features and long-term follow-up. We treated all patients with a combination of high-dose methotrexate and alkylating agents.
Results:
Five patients were diagnosed with histologically confirmed primary neurolymphomatosis. The majority of them presented with painful asymmetric sensory-motor neuropathy. Magnetic resonance imaging was abnormal in 4 of 5 patients, as shown with gadolinium enhancements. Electroneuromyography revealed denervation in all 4 cases with contributive examinations. All our patients received a chemotherapy combination of high-dose methotrexate and alkylating agent. Median progression-free survival was 8 months (2 complete responses and 2 partial responses), and overall survival was 24 months.
Conclusions:
Primary neurolymphomatosis is rare and polymorphic; it represents a difficult diagnosis of neuropathy. In our cohort, treatment with a chemotherapy combination with high-dose methotrexate showed encouraging results.
