Presentation of intravascular lymphomatosis as lumbosacral polyradiculopathy.
A 53-year-old man developed progressive sensory disturbance and weakness in the legs, sphincter disturbance, back pain, systemic symptoms, and pancytopenia. Electrophysiological tests indicated a widespread lumbosacral polyradiculopathy. Spinal magnetic resonance imaging and routine cerebrospinal fluid analysis showed minor nonspecific abnormalities. Bone marrow and liver biopsies showed hemophagocytosis; and polymerase chain reaction of cerebrospinal fluid, bone marrow, and serum suggested active infection with human herpesvirus-6. Autopsy revealed that his neurological symptoms resulted from intravascular lymphomatosis (angiotropic large cell lymphoma), a rare variant of lymphoma with predilection for the nervous system.
Department of Neurology, Auckland Hospital, New Zealand.
S
S
Viali
D O
DO
Hutchinson
T E
TE
Hawkins
M C
MC
Croxson
M
M
Thomas
J P
JP
Allen
S M
SM
Thomas
K H
KH
Powell
D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006566:Herpesviridae Infections / Q000175:diagnosis; D015654:Herpesvirus 6, Human; D006801:Humans; D008161:Lumbosacral Region; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications* / Q000175:diagnosis* / Q000821:virology; D008297:Male; D008875:Middle Aged; D010198:Pancytopenia / Q000175:diagnosis; D011128:Polyradiculopathy / Q000175:diagnosis* / Q000209:etiology* / Q000821:virology