Sumi S M, Farrell D F, Knauss T A
Arch Neurol. 1983 Sep;40(9):577-82. doi: 10.1001/archneur.1983.04050080077016.
Subacute polyneuropathy that responded to prednisone was the initial symptom in two patients, one of whom was later found to have histiocytic lymphoma and the other, chronic lymphocytic leukemia. Sural nerve biopsy specimens in both showed extensive segmental demyelination. In the first patient, there was invasion of the myelinated axons by macrophage processes, and the later course of the neuropathy appeared to parallel that of the lymphoma. In the second patient, there was diffuse lymphocytic infiltration of the perineurium and endoneurium, lymphocytes were found beneath the basal lamina, and the demyelination was characterized by extensive vesicular degeneration of the myelin sheath. The demyelination appeared to be cell mediated in the first patient. This was probably the mechanism in the second patient as well, but simple mechanical compression by infiltrating leukemic cells was another possible explanation.
两名患者最初的症状是对泼尼松有反应的亚急性多发性神经病，其中一名患者后来被发现患有组织细胞淋巴瘤，另一名患有慢性淋巴细胞白血病。两人的腓肠神经活检标本均显示广泛的节段性脱髓鞘。在第一名患者中，巨噬细胞过程侵入有髓轴突，并且神经病的后期病程似乎与淋巴瘤的病程平行。在第二名患者中，神经束膜和神经内膜有弥漫性淋巴细胞浸润，在基膜下发现淋巴细胞，脱髓鞘的特征是髓鞘广泛的水泡样变性。在第一名患者中，脱髓鞘似乎是细胞介导的。这在第二名患者中可能也是机制，但白血病细胞浸润引起的单纯机械压迫是另一种可能的解释。
