Paraneoplastic syndrome simulating encephalitis in the course of testicular seminoma.
A case of paraneoplastic syndrome diagnosed post mortem in a 68-year-old man with a single submandibular lymphatic metastasis of testicular seminoma is presented. The syndrome developed 3 years after orchidectomy and clinically combined the features of limbic and bulbar encephalitis together with signs of cerebellar degeneration. Histological examination revealed marked loss of cerebellar Purkinje and granular cells and to a lesser extent of cerebral cortical neurons. Additionally axonal injury (spheroids) and multifocal demyelination with sparse lymphocytic infiltrations was observed. Immunohistochemically, strong reaction with monoclonal anti-human IgG in some neurons of cerebellum was detected whereas the reaction with anti-complement (C3b) receptor in corresponding sections was negative. It is suggested that the presented case may represent a "burn out" stage of paraneoplastic syndrome associated with anti-neuronal antibodies, however the isolation of specific antibodies was not performed.
Kałuza
J
J
Department of Neuropathology, Jagiellonian University, Kraków.
Słowiński
J
J
Bujny
T
T
Grochala
M
M
D000368:Aged; D001284:Atrophy; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D001927:Brain Diseases / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D002525:Cerebellar Cortex / Q000473:pathology; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004660:Encephalitis / Q000175:diagnosis*; D017809:Fatal Outcome; D006258:Head and Neck Neoplasms / Q000150:complications / Q000556:secondary*; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008207:Lymphatic Metastasis; D008297:Male; D009410:Nerve Degeneration; D010257:Paraneoplastic Syndromes / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D018239:Seminoma / Q000150:complications / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D013736:Testicular Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery
D007074:Immunoglobulin G