title: Negative sural nerve biopsy in neurolymphomatosis.
abstract: Patients with non-Hodgkin's lymphoma occasionally develop widespread invasion of peripheral nerves by tumor cells or neurolymphomatosis (NL). Clinically this usually results in asymmetrical, progressive, and painful polyneuropathy. Diagnosis rests on the identification of tumor cells in peripheral nerves. To avoid false-negative biopsy findings in patients with malignant lymphomatous infiltration of peripheral nerves it has been recommended to biopsy clinically involved nerves. We present two patients with histologically confirmed NL in whom sural the nerve biopsy finding was negative despite clinical and neurophysiological evidence of involvement of the sural nerve a. The clinical features of NL are reviewed. Some patients with neurolyphomatosis have only focal or proximal involvement of nerves, requiring the biopsy of an affected part of these nerves. Magnetic resonance imaging may be useful in identifying affected nerves.
authors.affiliation: Department of Neuro-oncology, Dr. Daniel den Hoed Cancer Center, Rotterdam, The Netherlands. bent@neuh.azr.nl
authors.forename: M J
authors.initials: MJ
authors.lastname: van den Bent
authors.forename: H G
authors.initials: HG
authors.lastname: de Bruin
authors.forename: G M
authors.initials: GM
authors.lastname: Bos
authors.forename: G
authors.initials: G
authors.lastname: Brutel de la Rivière
authors.forename: P A
authors.initials: PA
authors.lastname: Sillevis Smitt
mesh_terms: D000328:Adult; D001706:Biopsy; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D010525:Peripheral Nerves / Q000473:pathology* / Q000503:physiopathology; D013497:Sural Nerve / Q000473:pathology* / Q000503:physiopathology