[A case of B-cell type acute lymphocytic leukemia presenting ophthalmoplegia]

A 72-year-old man suddenly developed right blepharoptosis and diplopia and subsequently experienced motor and sensory disturbances in his upper and lower limbs. Soon he developed violet eruptions on his trunk and extremities. Approximately 2 months after the onset of his neurological symptoms, laboratory tests confirmed a diagnosis of B-cell type acute lymphocytic leukemia. The patient died 5 days later. Autopsy findings comprised prominent intrafascicular infiltration of leukemic cells in multiple peripheral nerves, including cranial and dorsal roots. However, there was no parenchymal involvement except in the dorsal root ganglia. In acute leukemia, infiltration of malignant cells in the peripheral nervous system has been reported to be uncommon compared with that in malignant lymphoma. This case of acute lymphocytic leukemia was considered to be unique with regard to the onset of neurological symptoms and autopsy findings.