Hughes R A, Britton T, Richards M
Department of Neurology, UMDS, Guy's Hospital, London, UK.
J R Soc Med. 1994 Sep;87(9):526-30. doi: 10.1177/014107689408700915.
Peripheral nervous system abnormalities occur in 5% of patients with lymphoma and have a wide differential diagnosis. Herpes zoster is the commonest cause. Vinca alkaloids are the only drugs used in lymphoma which commonly cause neuropathy. Compression or infiltration of nerve roots by lymphoma is a rare presenting feature but becomes more common with advanced disease. Radiation plexopathy does not usually develop until at least 6 months after irradiation and can be difficult to distinguish from neoplastic infiltration. Either multifocal infiltration of nerves or lymphoma-associated vasculitis may present as a peripheral neuropathy. The incidence of Guillain-Barré (GBS) syndrome, and possibly chronic idiopathic demyelinating polyradiculoneuropathy, appears to be increased in association with lymphoma, especially Hodgkin's disease. Subacute sensory neuronopathy and subacute lower motor neuronopathy have both been reported as paraneoplastic syndromes associated with Hodgkin's disease. Treatment of the underlying lymphoma is only rarely followed by recovery of the associated neuropathy.
5%的淋巴瘤患者会出现周围神经系统异常，其鉴别诊断范围广泛。带状疱疹是最常见的病因。长春花生物碱是淋巴瘤治疗中唯一常用且通常会导致神经病变的药物。淋巴瘤压迫或浸润神经根是一种罕见的临床表现，但在疾病晚期更为常见。放射性臂丛神经病通常在放疗后至少6个月才会出现，且可能难以与肿瘤浸润相区分。神经多灶性浸润或淋巴瘤相关血管炎都可能表现为周围神经病变。格林-巴利（GBS）综合征以及可能的慢性特发性脱髓鞘性多发性神经根神经病的发病率，似乎在淋巴瘤患者中有所增加，尤其是霍奇金病。亚急性感觉神经元病和亚急性下运动神经元病均被报道为与霍奇金病相关的副肿瘤综合征。对潜在淋巴瘤进行治疗后，相关神经病变很少会恢复。
