Bakshi Neha, Chand Vineeta, Anand Rajiv, Duggal Rajan
Department of Pathology (Histopathology Division), Sir Ganga Ram Hospital, New Delhi, India.
Department of Histopathology and Cytopathology, BLK-MAX Hospital, New Delhi, India.
Indian J Pathol Microbiol. 2024 Oct 1;67(4):918-920. doi: 10.4103/ijpm.ijpm_731_22. Epub 2023 Jul 19.
Neurolymphomatosis (NL) is the direct infiltration of the peripheral nervous system (PNS) by lymphoma cells and represents the least common form of PNS involvement by lymphoma. Clinical presentation is varied, and early diagnosis remains challenging. Nerve biopsy remains the diagnostic gold standard, use of magnetic resonance imaging (MRI) and fluorodeoxyglucose-positron emission tomography (FDG-PET) may help in diagnosis and selecting targets for biopsy. We report an account of an older male patient who presented with subacute onset multifocal neuropathy involving bilateral lower limbs and left foot drop. The patient was initially misdiagnosed as chronic inflammatory demyelinating polyneuropathy; however radiological assessment revealed fusiform thickening of the L5 nerve root and biopsy from the site revealed extensive infiltration by diffuse large B cell type non-Hodgkin lymphoma (NHL). High index of suspicion is vital to ensure correct diagnosis, timely treatment, and to improve patient survival.