title: High-dose intravenous methotrexate followed by autologous stem cell transplantation as a potentially effective therapy for neurolymphomatosis.
abstract: BACKGROUND
  Neurolymphomatosis (NL) is a rare neurologic manifestation of systemic lymphoma characterized by lymphomatous infiltration of the peripheral nervous system. The diagnosis of NL is difficult and requires a multidisciplinary approach for obtaining an adequate biopsy specimen of the suspected nerve. The prognosis of patients with NL has been poor because adequate penetration of chemotherapy into the nervous system is difficult.
  
  
  METHODS
  The authors presented the case of a 37-year-old man who was treated for Ann Arbor Stage IVB diffuse large B-cell lymphoma. The patient developed disease recurrence in the sciatic nerve without systemic involvement.
  
  
  RESULTS
  The patient achieved a clinical response after receipt of high-dose intravenous methotrexate followed by high-dose chemotherapy and autologous stem cell transplant.
  
  
  CONCLUSIONS
  The authors reported this case to highlight the effectiveness of this regimen in a rare and fatal disorder. In the current study they also reviewed the literature regarding the diagnosis, prognosis, and treatment of NL.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Irene M
authors.initials: IM
authors.lastname: Ghobrial
authors.forename: Francis
authors.initials: F
authors.lastname: Buadi
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Spinner
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Colgan
authors.forename: Alexandra P
authors.initials: AP
authors.lastname: Wolanskyj
authors.forename: P James
authors.initials: PJ
authors.lastname: Dyck
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Witzig
authors.forename: Ivana N
authors.initials: IN
authors.lastname: Micallef
authors.forename: Brian Patrick
authors.initials: BP
authors.lastname: O'Neill
mesh_terms: D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D001717:Birds; D003131:Combined Modality Therapy; D006801:Humans; D007262:Infusions, Intravenous; D016393:Lymphoma, B-Cell / Q000473:pathology / Q000628:therapy*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D010524:Peripheral Nervous System Neoplasms / Q000473:pathology / Q000628:therapy*; D012584:Sciatic Nerve / Q000473:pathology; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous
chemical_list: D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate