Disseminated intravascular large‐cell lymphoma with initial presentation mimicking Guillain–Barré syndrome

• Published in: Muscle & nerve Vol. 42; no. 1; pp. 133 - 136
• Main Authors: Jiang, Qin Li, Pytel, Peter, Rowin, Julie
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-07-2010; Wiley
• Subjects: Anti-Inflammatory Agents - therapeutic use; Autopsy; Axons - pathology; Biological and medical sciences; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction; Diagnosis, Differential; Electrodiagnosis; Fatal Outcome; Guillain-Barre Syndrome - cerebrospinal fluid; Guillain-Barre Syndrome - diagnosis; Guillain-Barre Syndrome - pathology; Guillain‐Barré syndrome; Humans; intravascular large cell lymphoma; Lymphoma, Large-Cell, Immunoblastic - cerebrospinal fluid; Lymphoma, Large-Cell, Immunoblastic - chemically induced; Lymphoma, Large-Cell, Immunoblastic - pathology; Male; Medical sciences; Middle Aged; mononeuropathy multiplex; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Muscle Strength - physiology; Muscle Weakness - etiology; Muscle, Skeletal - pathology; necrotizing vasculitis; Nervous system (semeiology, syndromes); Neural Conduction - physiology; Neurology; Peripheral Nerves - physiopathology; Peripheral Nervous System Diseases - etiology; Peripheral Nervous System Diseases - pathology; Pupil - physiology; Respiratory Insufficiency - etiology; Steroids - therapeutic use; transbronchial biopsy; Human; transbronchial biopsy; Nervous system diseases; Intravascular lymphoma; Necrotizing vasculitis; Cardiovascular disease; Malignant hemopathy; Large cell lymphoma; Neuropathy; Non Hodgkin lymphoma; Polyneuropathy; Guillain-Barré syndrome; Inflammatory disease; Vascular disease; Biopsy; Lymphoproliferative syndrome; Sensory disorder; intravascular large cell lymphoma; Peripheral nerve disease; Diagnosis; Cancer; mononeuropathy multiplex
• ISSN: 0148-639X; 1097-4598
• DOI: 10.1002/mus.21648

We report a patient with intravascular large B‐cell lymphoma who initially presented with acute ascending weakness and sensory changes. Electrodiagnostic testing and cerebral spinal fluid (CSF) studies were initially suggestive of a demyelinating polyneuropathy. Further clinical evaluation and testing were consistent with mononeuropathy multiplex. Autopsy revealed disseminated intravascular large‐cell lymphoma. Intravascular large‐cell lymphoma should be considered in the differential diagnosis of a rapidly evolving neuropathy associated with other organ involvement. Muscle Nerve, 2010