A case of cranial multinevritis: from the onset to the diagnosis of primary neurolymphomatosis

Neurolymphomatosis (NL) is a rare peripheral or cranial neuropathy caused by non-Hodgkin’s lymphoma (NHL). Diagnosis is often delayed and prognosis is poor. The authors described a woman in her 70s with a facial left peripheral palsy, complete right abducent palsy, left hypoacusia and balance defici...

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Bibliographic Details
Published in:BMJ case reports 2012-06, Vol.2012 (jun13 1), p.bcr0620114299-bcr0620114299
Main Authors: Vecchio, Domizia, Mittino, Daniela, Terazzi, Emanuela, Luca, Nassi, Conconi, Annarita, Monaco, Francesco
Format: Article
Language:English
Subjects:
Aged
Bone marrow
Cellular biology
Chemotherapy
Cranial Nerve Diseases - diagnostic imaging
Cranial Nerve Diseases - pathology
Cranial Nerves - pathology
Diagnosis, Differential
Europe (West)
Facial Paralysis - diagnostic imaging
Facial Paralysis - pathology
Family medical history
Female
Follow-Up Studies
Glucose
Humans
Immunoglobulins
Lymphocytes
Lymphoma
Lymphoma, Non-Hodgkin - diagnosis
Lymphoma, Non-Hodgkin - pathology
Magnetic Resonance Imaging
Medical imaging
Peripheral Nervous System Neoplasms - diagnostic imaging
Peripheral Nervous System Neoplasms - pathology
Rare Disease
Spinal cord
Tomography, X-Ray Computed
White
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Summary:Neurolymphomatosis (NL) is a rare peripheral or cranial neuropathy caused by non-Hodgkin’s lymphoma (NHL). Diagnosis is often delayed and prognosis is poor. The authors described a woman in her 70s with a facial left peripheral palsy, complete right abducent palsy, left hypoacusia and balance deficit. Then she presented with low progressive hyposthenia at four limbs and cognitive impairment, sudden facial right peripheral palsy and complete left abducent palsy. The authors performed brain and spinal MRI, cerebrospinal fluid (CSF) analysis and extensive haematological examinations for infections, autoimmune and neoplastic diseases. All the results were not diagnostic. Only repeating for the third time a spinal tap, CSF presented neoplastic B cells suggestive for large B-NHL. The authors diagnosed primary NL. The patient was treated with R-CHOP but she died 2 months later. In front of rapidly progressive neuropathy, a NL has to be considered performing different examinations, especially and repeating them after a short period.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr.06.2011.4299