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Hypertrophic brachial plexus neuritis: A pathological study of two cases
Author(s) -
Cusimano Michael D.,
Bilbao Juan M.,
Cohen Sandra M.
Publication year - 1988
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410240505
Subject(s) - medicine , brachial plexus , pathology , pathological , histiocyte , neuritis , inflammation , nerve sheath tumor , edema , plexus , anatomy , surgery , schwannoma
Two patients with brachial plexus neuropathy had recurrent symptoms for years that culminated in the development of a Painful lower cervical mass. On macroscopic examination the affected nerves had a fusiform segmental enlargement, suggestive of a nerve sheath tumor, that was excised. Histologically, Marchked endoneurial edema, florid focal chronic inflammation, extensive onion bulb formation, and perineurial sparing were seen. Electron microscopic studies on one patient revealed microvasculitis; frequent tubuloreticular inclusions in endothelial cells, histiocytes, and lymphocytes; and cylindrical confronting cisternae in lymphocytes. We conclude that some cases of recurrent brachial plexus neuropathy are due to a localized chronic inflammation that may be related to autoimmunity or to a viral infection.