Gwathmey Kelly G
Department of Neurology, University of Virginia, Charlottesville, VA, United States.
Handb Clin Neurol. 2018;149:257-279. doi: 10.1016/B978-0-12-811161-1.00017-7.
Cancer in the form of solid tumors, leukemia, and lymphoma can infiltrate and metastasize to the peripheral nervous system, including the cranial nerves, nerve roots, cervical, brachial and lumbosacral plexuses, and, rarely, the peripheral nerves. This review discusses the presentation, diagnostic evaluation, and treatment options for metastatic lesions to these components of the peripheral nervous system and is organized based on the anatomic distribution. As skull base metastases (also discussed in Chapter 14) result in cranial neuropathies, these will be covered in detail, as well as cancers that directly infiltrate the cranial nerves. Particular emphasis is placed on the clinical, imaging, and electrodiagnostic features that differentiate neoplastic plexopathies from radiation-induced plexopathies. Neurolymphomatosis, in which malignant lymphocytes invade the cranial nerves, nerve roots, brachial and lumbosacral plexuses, and peripheral nerves, is a rare manifestation of lymphoma and leukemia. Diagnoses of neurolymphomatosis are often missed or delayed given its varied presentations, resulting in poorer outcomes. Thus this disease will also be discussed in depth.
实体瘤、白血病和淋巴瘤形式的癌症可浸润并转移至周围神经系统，包括脑神经、神经根、颈丛、臂丛和腰骶丛，很少累及周围神经。本综述讨论了转移至周围神经系统这些组成部分的病变的临床表现、诊断评估和治疗选择，并根据解剖分布进行组织。由于颅底转移瘤（第14章也有讨论）会导致脑神经病变，因此将详细介绍这些病变以及直接浸润脑神经的癌症。特别强调了区分肿瘤性神经丛病变与放射性神经丛病变的临床、影像学和电诊断特征。神经淋巴瘤病是淋巴瘤和白血病的一种罕见表现，其中恶性淋巴细胞侵犯脑神经、神经根、臂丛和腰骶丛以及周围神经。鉴于神经淋巴瘤病表现多样，其诊断常常被漏诊或延误，导致预后较差。因此，也将深入讨论这种疾病。
