Pagès M, Girard-Herpe M, Rousset T, Pagès A-M
Service de Neurologie A, Centre Gui-de-Chauliac, Montpellier.
Rev Neurol (Paris). 2005 Sep;161(8-9):823-8. doi: 10.1016/s0035-3787(05)85141-0.
Identifying tumor infiltration or compression in patients with non-Hodgkin's malignant lymphoma presenting peripheral neuropathy can be a difficult task.
We collected a series of patients with peripheral neuropathy with demonstrated lymphomatous infiltration or compression managed between October 1977 and October 2001 to search for clinico-pathological correlations.
Ten cases were reviewed. Neurological manifestations were the inaugural symptom of the disease in 7 patients. Clinical presentations included 5 focal (3 cranial nerve palsies, 2 brachial radiculopathies) and 5 diffuse neuropathies (3 polyradiculoneuropathies, 1 polyneuropathy and 1 mononeuritis multiplex). The mechanisms of peripheral nerve involvement were classified into lymphomatous meningoradiculitis (5 cases), involvement of cranial nerves or spinal roots in their extraneuraxial course (3 cases) and infiltration of distal peripheral nerves (2 cases). Four long lasting survivals after treatment were observed.
Prognosis depends much more on the haematological disease than on the neurological symptoms or tumor location.
对于患有周围神经病变的非霍奇金恶性淋巴瘤患者，识别肿瘤浸润或压迫可能是一项艰巨的任务。
我们收集了一系列在1977年10月至2001年10月期间接受治疗的、已证实存在淋巴瘤浸润或压迫的周围神经病变患者，以寻找临床病理相关性。
回顾了10例病例。7例患者的神经学表现为疾病的首发症状。临床表现包括5例局灶性病变（3例颅神经麻痹、2例臂丛神经根病）和5例弥漫性神经病变（3例多神经根神经病、1例多发性神经病和1例多灶性单神经病）。周围神经受累的机制分为淋巴瘤性脑脊神经根炎（5例）、颅神经或脊神经根在神经外行程中的受累（3例）以及远端周围神经浸润（2例）。观察到4例治疗后长期存活。
预后更多地取决于血液系统疾病，而非神经学症状或肿瘤位置。
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