Sonobe M, Yasuda H, Okabe H, Terada M, Maeda K, Kawabata T, Kikkawa R
Third Department of Medicine, Shiga University of Medical Science, Ohtsu.
Intern Med. 1998 Jul;37(7):631-4. doi: 10.2169/internalmedicine.37.631.
A 75-year-old woman was admitted because of pain and numbness in the extremities and trunk. She subsequently suffered from lymphadenopathy and spiky fever. The immunohistochemical analysis of the biopsied lymph nodes and sural nerve and electrophysiological examination supported a diagnosis of angioimmunoblastic lymphadenopathy-like T cell lymphoma with polyneuropathy. The infiltrating lymphoma cells of the sural nerve and lymph node shared the same phenotype (CD45RO, CD3, CD30 positive). An increased expression of HLA-DR antigen was observed in endothelial and Schwann cells. Chemotherapy with CHOP-Bleomycin markedly relieved her pain. These findings suggest that a direct lymphocytic infiltration in the nerve may be associated with neuropathy in this case.
一名75岁女性因四肢和躯干疼痛及麻木入院。随后她出现淋巴结病和高热。对活检的淋巴结和腓肠神经进行免疫组织化学分析及电生理检查支持血管免疫母细胞性淋巴结病样T细胞淋巴瘤伴多发性神经病的诊断。腓肠神经和淋巴结中浸润的淋巴瘤细胞具有相同的表型（CD45RO、CD3、CD30阳性）。在内皮细胞和施万细胞中观察到HLA-DR抗原表达增加。CHOP-博来霉素化疗显著缓解了她的疼痛。这些发现提示在该病例中神经内淋巴细胞的直接浸润可能与神经病相关。
