Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of neurolymphomatosis presenting extended involvement of spinal nerve roots

Masayuki Sato, M.D.1), Minori Furuta, M.D.1), Kimitoshi Hirayanagi, M.D.1), Shun Nagamine, M.D.1), Kouki Makioka, M.D., Ph.D.1) and Yoshio Ikeda, M.D., Ph.D.1)

1)Department of Neurology, Gunma University Graduate School of Medicine

A 56-year-old man suffered from diffuse large B-cell lymphoma (DLBCL) originated from the stomach. He received R-CHOP therapy, and had a complete remission. However, at age 57, he experienced left shoulder pain and weakness of left arm, and his muscle weakness and sensory disturbance subacutely progressed to other limbs. Cervical and lumbosacral MRI showed enhanced extended lesions of cervical, thoracic, lumbar, and sacral nerve roots and cauda equina. Cerebrospinal fluid analysis revealed a sustained low glucose level. Nerve conduction study showed abnormalities of measurement parameters of F-waves in all limbs. A diagnosis of recurrent DLBCL presenting neurolymphomatosis could be established by repeated cytology of cerebrospinal fluid. He received high dose methotrexate therapy, but his symptoms were worsened to tetraplegia. It should be noticed that DLBCL can involve spinal nerve roots extensively.
Full Text of this Article in Japanese PDF (604K)

(CLINICA NEUROL, 55: 333|338, 2015)
key words: diffuse large B-cell lymphoma, neurolymphomatosis, cytology of cerebrospinal fluid, extended radiculopathy

(Received: 15-May-14)