title: HIV lumbosacral radiculoplexus neuropathy mimicking lymphoma: diffuse infiltrative lymphocytosis syndrome (DILS) restricted to nerve?
abstract: Diffuse infiltrative lymphocytosis syndrome (DILS) is a hyperimmune reaction against HIV. It leads to MHC-restricted clonal expansion of CD8 T cells characterized by circulating CD8 hyperlymphocytosis and CD8 T-cell infiltration in organs. Our patient presented with painful lumbosacral radiculoplexus neuropathy and tested positive for HIV. Nerve biopsy showed large collections of CD8 lymphocytes suspicious for lymphoma. Symptoms, signs, and repeat biopsy improved with antiretroviral treatment. The presentation and treatment response suggest that this case is localized DILS.
authors.affiliation: Peripheral Neuropathy Research Laboratory, Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Nizar
authors.initials: N
authors.lastname: Chahin
authors.forename: Zelalem
authors.initials: Z
authors.lastname: Temesgen
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Kurtin
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Spinner
authors.forename: P James B
authors.initials: PJ
authors.lastname: Dyck
mesh_terms: D016263:AIDS-Associated Nephropathy / Q000175:diagnosis* / Q000473:pathology; D001706:Biopsy; D018414:CD8-Positive T-Lymphocytes / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D008218:Lymphocytosis / Q000175:diagnosis* / Q000473:pathology; D016483:Lymphoma, AIDS-Related / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011843:Radiculopathy / Q000175:diagnosis* / Q000473:pathology; D013126:Spinal Nerve Roots / Q000473:pathology; D013577:Syndrome