Khan Nadir
Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK.
BMJ Case Rep. 2018 Jun 15;2018:bcr-2017-224100. doi: 10.1136/bcr-2017-224100.
A 31-year-old man presented with a subacute cerebellar syndrome of unknown aetiology. Investigations including a paraneoplastic antibody screen were negative and a working diagnosis of possible vasculitis was concluded. After 1 month, he re-presented with worsening of his symptoms and a neck lump. He was diagnosed with anaplastic lymphoma kinase, negative non-Hodgkin's lymphoma and paraneoplastic cerebellar syndrome. A more extensive paraneoplastic antibody screen found patient to be Tr (delta/notch-like epidermal growth factor-related receptor) antibody positive. After a period of chemotherapy and steroid treatments, his symptoms are now stable in terms of cerebellar function. This case report summarises a very rare diagnosis of paraneoplastic cerebellar degeneration with a positive onconeuronal antibody associated with anaplastic non-Hodgkin's lymphoma.
一名31岁男性出现病因不明的亚急性小脑综合征。包括副肿瘤抗体筛查在内的各项检查均为阴性,得出可能为血管炎的初步诊断。1个月后,他因症状加重和颈部肿块再次就诊。他被诊断为间变性淋巴瘤激酶阴性的非霍奇金淋巴瘤和副肿瘤性小脑综合征。更广泛的副肿瘤抗体筛查发现患者Tr(δ/Notch样表皮生长因子相关受体)抗体呈阳性。经过一段时间的化疗和类固醇治疗,他目前小脑功能方面的症状稳定。本病例报告总结了一种非常罕见的副肿瘤性小脑变性诊断,其肿瘤神经元抗体呈阳性,与间变性非霍奇金淋巴瘤相关。