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Neurolymphomatosis: a rare cause of mononeuritis multiplex

2015; Elsevier BV; Volume: 357; Linguagem: Inglês

10.1016/j.jns.2015.08.603

1878-5883

Biplab Das, Manoj Goyal, Manish Modi, Vivek Lal, Sameer Vyas, B. D. Radotra, BR Mittal,

CNS Lymphoma Diagnosis and Treatment

Abstract: Background: Neurolymphomatosis, direct invasion of peripheral nerves by lymphoma cells is a rare presentation of lymphoma. We report four cases of Neurolymphomatosis who presented to us with peripheral neuropathy. Objective: To describe four patients of Neurolymphomatosis, presenting as mononeuritis multiplex. Patients and results: Four elderly gentlemen presented to us during last one year. While one presented with sciatic mononeuropathy, other three presented with clinical picture suggestive of mononeuritis multiplexa. In two patients diagnosis was made by nerve biopsy, in one at autopsy and in one by ancillary investigations including PET. PET showed increased uptake in different nerve trunks in all three patients in whom it was carried out. Nerve conduction studies revealed axonal neuropathy in two patients and mixed axonal-demyelinating neuropathy in two. All the four patients received incorrect diagnosis before evaluation in our center. Conclusions: Neurolymphomatosis is a rare cause of mononeuritis multiplex, which need to be kept in mind while evaluating patient with mononeuritis multiplexa. Detailed investigations including whole body PET scan and nerve biopsy help in reaching a correct diagnosis in majority of patients.