Thickening of multiple cranial nerves in a patient with extranodal peripheral T-cell lymphoma.
A 57-year-old male became aware of a subcutaneous tumor in March 2001. Histopathological examination showed peripheral T-cell lymphoma. He achieved complete remission after chemotherapy. Later the lymphoma relapsed in the subcutaneous lesion and chemotherapy was performed again. In April 2003, he developed diplopia, dysarthria, and dysphagia. Abnormal lymphoid cells were found in the cerebrospinal fluid. An immunophenotypical study disclosed that CD2, CD3, CD5, and CD8 were positive. Rearrangement of TCR was detected by Southern blotting. Cranial magnetic resonance imaging did not detect any intraparenchymal lesions, but thickening of multiple cranial nerves was detected. These nerves were homogeneously enhanced by gadolinium-DTPA. After intrathecal chemotherapy, atypical cells disappeared from the cerebrospinal fluid and thickening of the cranial nerves was resolved. Finally, lymphoma spread to the bone marrow, and the patient died in July 2003.
Matano
Sadaya
S
Department of Hematology, Tonami General Hospital, 1-61, Shintomi-cho, Tonami, Toyama, 939-1395, Japan. eievui7@p1.tst.ne.jp
Shirasaki
Hiroe
H
Terahata
Shintarou
S
Nobata
Koji
K
Sugimoto
Tatsuho
T
D019046:Bone Marrow Neoplasms / Q000556:secondary; D003287:Contrast Media; D003391:Cranial Nerves / Q000473:pathology*; D017809:Fatal Outcome; D019786:Gadolinium DTPA; D006801:Humans; D016411:Lymphoma, T-Cell, Peripheral / Q000188:drug therapy / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local
D003287:Contrast Media; D019786:Gadolinium DTPA