Diffuse large B-cell lymphoma presenting with neurolymphomatosis and intravascular lymphoma: a unique autopsy case with diverse neurological symptoms

A 78-year-old Japanese male noticed a difficulty in the beginning of standing up, followed by 7a progressive numbness of extremities with pain, Bell’s palsy, dysarthria, and difficulty in swallowing. A clinician had suspected cancer of unknown primary origin, accompanied by the diverse and elusive n...

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Main Authors:	Yamada, Sohsuke, Tanimoto, Akihide, Nabeshima, Atsunori, Tasaki, Takashi, Wang, Ke-Yong, Kitada, Shohei, Noguchi, Hirotsugu, Sasaguri, Yasuyuki
Format:	Online
Language:	English
Published:	BioMed Central 2012
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3449208/

id	pubmed-3449208
recordtype	oai_dc
spelling	pubmed-34492082012-09-24 Diffuse large B-cell lymphoma presenting with neurolymphomatosis and intravascular lymphoma: a unique autopsy case with diverse neurological symptoms Yamada, Sohsuke Tanimoto, Akihide Nabeshima, Atsunori Tasaki, Takashi Wang, Ke-Yong Kitada, Shohei Noguchi, Hirotsugu Sasaguri, Yasuyuki Case Report A 78-year-old Japanese male noticed a difficulty in the beginning of standing up, followed by 7a progressive numbness of extremities with pain, Bell’s palsy, dysarthria, and difficulty in swallowing. A clinician had suspected cancer of unknown primary origin, accompanied by the diverse and elusive neurological symptoms, likely presenting as painful mononeuropathy simplex and cranial neuropathy. He developed dysbasia over weeks and died 1 month after the symptom onset. At autopsy, an ill-defined large and soft tumor mass in the right lobe of the liver with direct invasion into the right adrenal gland was observed. The left adrenal gland or right iliopsoas muscle was also involved. Microscopic findings showed a monotonous proliferation of medium-sized to large atypical lymphoid cells, which were diffusely positive for CD20 in immunohistochemistry, consistent with diffuse large B-cell lymphoma (DLBL). Furthermore, the lymphoma cells aggressively infiltrated endoneurial and subperineurial spaces not only in the peripheral nerves and plexuses, but partly in the spinal nerve roots, and intravascular spaces in various tissues. Therefore, systemic lymphoma (DLBL) complicated with neurolymphomatosis (NL) and intravascular lymphoma (IVL) was diagnosed. Very early diagnosis and treatment are necessary for the NL patients with poor prognosis. BioMed Central 2012-08-13 /pmc/articles/PMC3449208/ /pubmed/22888848 http://dx.doi.org/10.1186/1746-1596-7-94 Text en Copyright ©2012 Yamada et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Yamada, Sohsuke Tanimoto, Akihide Nabeshima, Atsunori Tasaki, Takashi Wang, Ke-Yong Kitada, Shohei Noguchi, Hirotsugu Sasaguri, Yasuyuki
spellingShingle	Yamada, Sohsuke Tanimoto, Akihide Nabeshima, Atsunori Tasaki, Takashi Wang, Ke-Yong Kitada, Shohei Noguchi, Hirotsugu Sasaguri, Yasuyuki Diffuse large B-cell lymphoma presenting with neurolymphomatosis and intravascular lymphoma: a unique autopsy case with diverse neurological symptoms
author_facet	Yamada, Sohsuke Tanimoto, Akihide Nabeshima, Atsunori Tasaki, Takashi Wang, Ke-Yong Kitada, Shohei Noguchi, Hirotsugu Sasaguri, Yasuyuki
author_sort	Yamada, Sohsuke
title	Diffuse large B-cell lymphoma presenting with neurolymphomatosis and intravascular lymphoma: a unique autopsy case with diverse neurological symptoms
title_short	Diffuse large B-cell lymphoma presenting with neurolymphomatosis and intravascular lymphoma: a unique autopsy case with diverse neurological symptoms
title_full	Diffuse large B-cell lymphoma presenting with neurolymphomatosis and intravascular lymphoma: a unique autopsy case with diverse neurological symptoms
title_fullStr	Diffuse large B-cell lymphoma presenting with neurolymphomatosis and intravascular lymphoma: a unique autopsy case with diverse neurological symptoms
title_full_unstemmed	Diffuse large B-cell lymphoma presenting with neurolymphomatosis and intravascular lymphoma: a unique autopsy case with diverse neurological symptoms
title_sort	diffuse large b-cell lymphoma presenting with neurolymphomatosis and intravascular lymphoma: a unique autopsy case with diverse neurological symptoms
description	A 78-year-old Japanese male noticed a difficulty in the beginning of standing up, followed by 7a progressive numbness of extremities with pain, Bell’s palsy, dysarthria, and difficulty in swallowing. A clinician had suspected cancer of unknown primary origin, accompanied by the diverse and elusive neurological symptoms, likely presenting as painful mononeuropathy simplex and cranial neuropathy. He developed dysbasia over weeks and died 1 month after the symptom onset. At autopsy, an ill-defined large and soft tumor mass in the right lobe of the liver with direct invasion into the right adrenal gland was observed. The left adrenal gland or right iliopsoas muscle was also involved. Microscopic findings showed a monotonous proliferation of medium-sized to large atypical lymphoid cells, which were diffusely positive for CD20 in immunohistochemistry, consistent with diffuse large B-cell lymphoma (DLBL). Furthermore, the lymphoma cells aggressively infiltrated endoneurial and subperineurial spaces not only in the peripheral nerves and plexuses, but partly in the spinal nerve roots, and intravascular spaces in various tissues. Therefore, systemic lymphoma (DLBL) complicated with neurolymphomatosis (NL) and intravascular lymphoma (IVL) was diagnosed. Very early diagnosis and treatment are necessary for the NL patients with poor prognosis.
publisher	BioMed Central
publishDate	2012
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3449208/
_version_	1611911075558588416

Diffuse large B-cell lymphoma presenting with neurolymphomatosis and intravascular lymphoma: a unique autopsy case with diverse neurological symptoms

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