Autopsy report of acute necrotizing opticomyelopathy associated with thyroid cancer.
We report an autopsied case of paraneoplastic necrotizing myelopathy. The patient had bilateral blindness, quadriplegia, and dyspnea of acute onset and died without remission 7 weeks later. The severe tissue necrosis and demyelination were found in the optic chiasm and from the medulla oblongata throughout the whole length of spinal cord. A papillary carcinoma was found in the thyroid gland at autopsy. In the present case IgG, myelin basic protein and activated helper T cells were increased in the CSF at onset, suggesting a mechanism of autoimmune demyelination for the condition.
Kuroda
Y
Y
Department of Internal Medicine, Saga Medical School, Japan.
Miyahara
M
M
Sakemi
T
T
Matsui
M
M
Ryu
T
T
Yamaguchi
M
M
Sasadomi
E
E
Sugihara
H
H
D001327:Autoimmune Diseases / Q000473:pathology; D001344:Autopsy; D002291:Carcinoma, Papillary / Q000473:pathology*; D003711:Demyelinating Diseases / Q000473:pathology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid; D008526:Medulla Oblongata / Q000473:pathology*; D008875:Middle Aged; D004676:Myelin Basic Protein / Q000134:cerebrospinal fluid; D009336:Necrosis; D009897:Optic Chiasm / Q000473:pathology*; D010257:Paraneoplastic Syndromes / Q000134:cerebrospinal fluid / Q000473:pathology*; D013116:Spinal Cord / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000134:cerebrospinal fluid / Q000473:pathology*
D007074:Immunoglobulin G; D004676:Myelin Basic Protein