title: Sub-acute demyelinating polyradiculoneuropathy as an initial symptom of peripheral T cell lymphoma, not otherwise specified (PTCL-NOS).
abstract: Here we report the first case of peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), who initially presented with peripheral neuropathy. Nerve conduction, cerebral spinal fluid studies and his clinical course were compatible with sub-acute demyelinating polyradiculoneuropathy. In addition, left cervical lymph node swelling was observed on admission. Diagnosis of PTCL-NOS was made by the histological, immunohistochemical, and Southern blot analyses on the biopsy specimen from the enlarged lymph node. Combination chemotherapy composed of cyclophosphamide, vincristine, doxorubicin and prednisolone (CHOP) was effective for polyneuropathy as well as for lymphoma. Several antibodies relating to paraneoplastic syndrome such as Ma1, Ma2, Amphiphysin, CV2, Ri, Yo and Hu were all negative. Because sural nerve biopsy performed prior to CHOP therapy revealed no infiltration of lymphoma cells, immune dysfunction mediated by some cytokine or unidentified autoantibody related to PTCL-NOS was thought to be involved in the polyradiculoneuropathy.
authors.affiliation: Department of Internal Medicine, Kinki University, Japan.
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Kawanishi
authors.forename: Yasuyo
authors.initials: Y
authors.lastname: Ohyama
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Kanai
authors.forename: Tikara
authors.initials: T
authors.lastname: Hirase
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Tanaka
authors.forename: Junichi
authors.initials: J
authors.lastname: Miyatake
authors.forename: Youichi
authors.initials: Y
authors.lastname: Tatsumi
authors.forename: Takashi
authors.initials: T
authors.lastname: Ashida
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Nakamine
authors.forename: Itaru
authors.initials: I
authors.lastname: Matsumura
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D006801:Humans; D008198:Lymph Nodes / Q000276:immunology / Q000473:pathology; D016411:Lymphoma, T-Cell, Peripheral / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011129:Polyradiculoneuropathy / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology; D049268:Positron-Emission Tomography; D011239:Prednisolone / Q000008:administration & dosage; D013497:Sural Nerve / Q000473:pathology; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone