High-grade B-cell lymphoma manifested as peripheral nerve injury: A case report
1Department of Neurology, Shenzhen Longhua District Central Hospital, Shenzhen, Guangdong, China.
Medicine
|February 19, 2025
Summary
High-grade B-cell lymphoma can present as peripheral nerve injury, mimicking other conditions. Early lymph node biopsy is crucial for timely diagnosis and management of this aggressive cancer.
Area of Science:
- Oncology
- Neurology
- Hematology
Background:
- High-grade B-cell lymphoma is a rapidly progressing malignancy with a poor prognosis.
- Central nervous system involvement is common (9-45%), but peripheral nerve injury is rare.
- This case highlights a rare presentation of lymphoma with peripheral neuropathy.
Purpose of the Study:
- To report a rare case of high-grade B-cell lymphoma presenting with peripheral neuropathy.
- To emphasize the diagnostic challenges and the importance of early biopsy.
Main Methods:
- A 42-year-old male with recurrent facial paralysis and lower extremity weakness was evaluated.
- Diagnostic workup included fluorescence in situ hybridization (FISH) and clonal gene rearrangement tests.
- Genetic analysis revealed Bc16 and Myc translocations, confirming high-grade B-cell lymphoma.
Main Results:
- The patient was diagnosed with high-grade B-cell lymphoma based on genetic findings.
- Initial treatment involved chemotherapy, targeted therapy, and immunotherapy.
- The patient experienced recurrence and metastasis 5 years post-diagnosis, leading to death from organ failure.
Conclusions:
- Peripheral nerve injury can be an atypical initial manifestation of high-grade B-cell lymphoma.
- This presentation can be misdiagnosed as chronic inflammatory demyelinating polyradiculoneuropathy.
- Early lymph node biopsy is essential for accurate and timely diagnosis of lymphoma.
