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Splenic marginal zone lymphoma: An indolent malignancy leading to the development of neurolymphomatosis
Author(s) -
Groth Christopher L.,
Nevel Kathryn S.,
Gwathmey Kelly G.,
Bafakih Fahad,
Jones David E.
Publication year - 2017
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.25404
Subject(s) - medicine , nerve biopsy , polyradiculoneuropathy , biopsy , lymphoma , nerve root , malignancy , weakness , cerebrospinal fluid , differential diagnosis , surgery , radiology , pathology , peripheral neuropathy , guillain barre syndrome , endocrinology , immunology , diabetes mellitus
Acute neuropathic pain and weakness with a sensory level in a patient with a history of lymphoma has a broad differential diagnosis. Evaluation of such a presentation often includes MRI, neurophysiologic studies, and cerebrospinal fluid evaluation. We report a patient with splenic marginal zone lymphoma who developed acute weakness, sensory loss, and neuropathic pain due to neurolymphomatosis. Methods Clinical evaluation, MRI of the lumbar spine, cerebrospinal fluid evaluation, electrodiagnostic (EDx) studies, and biopsy of a dorsal nerve root were undertaken. Results EDx studies were consistent with an acute, acquired demyelinating sensorimotor polyradiculoneuropathy. Treatment with intravenous immunoglobulin and plasma exchange did not lead to clinical improvement. Ultimately, biopsy of a dorsal nerve root was performed and revealed neurolymphomatosis. Conclusion This case emphasizes that, when it can be performed safely, biopsy for suspected neurolymphomatosis is imperative for appropriate diagnosis and treatment. Muscle Nerve 55 : 440–444, 2017