Shimizu Ikuo, Hamano Yujiro, Sato Shunichi, Takeda Wataru, Kirihara Takehiko, Sato Keijiro, Ueki Toshimitsu, Hiroshima Yuki, Sumi Masahiko, Ueno Mayumi, Ichikawa Naoaki, Kobayashi Hikaru
Department of Hematology, Nagano Red Cross Hospital, Japan.
Intern Med. 2014;53(5):471-5. doi: 10.2169/internalmedicine.53.0262.
A 47-year-old man presented with a fever and lower extremity paresthesia. A physical examination revealed sensory deficits in the left hand, distal arm and right sole. A bone marrow aspiration demonstrated infiltration of extranodal NK/T-cell lymphoma, nasal type, and (18)F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) disclosed extensive involvement of the peripheral nerves. These findings were consistent with a diagnosis of neurolymphomatosis (NL). The lymphoma progressed soon after the patient underwent cord blood transplantation, and he died on day 33 after transplantation. NL is a rare manifestation of lymphoma characterized by infiltration of the peripheral nerves, leading to neuropathy. It is an increasingly recognized entity and can be the first indication of lymphoma.
一名47岁男性出现发热和下肢感觉异常。体格检查发现左手、手臂远端和右足底存在感觉缺陷。骨髓穿刺显示为鼻型结外NK/T细胞淋巴瘤浸润,(18)F-氟-2-脱氧葡萄糖正电子发射断层扫描(FDG-PET)显示外周神经广泛受累。这些发现符合神经淋巴瘤(NL)的诊断。患者接受脐血移植后淋巴瘤很快进展,于移植后第33天死亡。NL是淋巴瘤的一种罕见表现,其特征是外周神经浸润,导致神经病变。它是一种越来越被认识的疾病,可能是淋巴瘤的首发表现。