Lymphoplasmacytic lymphoma associated with polyradiculoneuritis and cryoglobulinemia mimicking polyarteritis nodosa.
BACKGROUND
Systemic vasculitis is sometimes associated with malignant blood disease.


METHODS
We describe the case of a 77-year-old woman who had extensive livedo racemosa, acute polyradiculoneuritis, and meningeal hemorrhage. The skin biopsy showed evidence of necrotizing angiitis. This vascular involvement resembled polyarteritis nodosa (PAN). Despite corticosteroid and cyclophosphamide treatment, the polyradiculoneuritis worsened and the patient died of acute respiratory failure. Type II cryoglobulinemia was detected late, and the autopsy revealed lymphoplasmacytic lymphoma involving the spleen and infiltrating nerve roots, together with necrotizing angiitis involving small-sized arteries.


CONCLUSIONS
This case shows that necrotizing angiitis involving small arteries may occur with type II cryoglobulinemia.
Mouthon
Luc
L
Paris-Descartes University, Faculty of Medicine, Department of Internal Medicine and National Reference Center for Vasculitides, Cochin Hospital, AP-HP, Paris. luc.mouthon@cch.ap-hop-paris.fr
Guilpain
Philippe
P
Martin
Antoine
A
Larroche
Claire
C
André
Marie Hélène
MH
Fouéré
Sébastien
S
Laroche
Liliane
L
Apartis
Emmanuelle
E
Guillevin
Loïc
L
D000368:Aged; D003449:Cryoglobulinemia / Q000209:etiology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis*; D010488:Polyarteritis Nodosa / Q000175:diagnosis; D011129:Polyradiculoneuropathy / Q000209:etiology*