title: CD5-positive diffuse large B cell lymphoma infiltrating the central nervous system presenting Guillain-Barré-like syndrome after chemotherapy.
abstract: An 83-year-old woman was admitted to our hospital with abdominal pain. Examination revealed mediastinal lymphoadenopathy, hepatosplenomegaly, and infiltration of abnormal cells into the bone marrow with hemophagocytosis, and CD5-positive diffuse large B cell lymphoma was diagnosed. Chemotherapy was administered and progressive weakness of the limbs, resembling a Guillain-Barré-like syndrome, subsequently appeared. Cerebrospinal fluid examination indicated lymphoma cell infiltration. Although immune globulin and steroid therapies were not effective, intrathecal injection of methotrexate, predonisolone, and cytarabine improved these symptoms. Subsequent to chemotherapy, cell surface antigen changes were observed in the cerebrospinal fluid relative to those in bone marrow.
authors.affiliation: Division of Pulmonary Medicine, National Hospital Organization National Kochi Hospital, Kochi, Japan. machidah@kochi2.hosp.go.jp
authors.forename: Hisanori
authors.initials: H
authors.lastname: Machida
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Shinohara
authors.forename: Nobuo
authors.initials: N
authors.lastname: Hatakeyama
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Okano
authors.forename: Mayuri
authors.initials: M
authors.lastname: Nakano
authors.forename: Makoto
authors.initials: M
authors.lastname: Tobiume
authors.forename: Keishi
authors.initials: K
authors.lastname: Naruse
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Iwahara
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Ogushi
mesh_terms: D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000235:genetics / Q000276:immunology; D000971:Antineoplastic Combined Chemotherapy Protocols; D018956:CD5 Antigens / Q000235:genetics / Q000276:immunology*; D002465:Cell Movement; D002490:Central Nervous System / Q000187:drug effects / Q000276:immunology / Q000473:pathology*; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D020275:Guillain-Barre Syndrome / Q000188:drug therapy / Q000209:etiology / Q000276:immunology / Q000473:pathology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects; D016403:Lymphoma, Large B-Cell, Diffuse / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*; D008727:Methotrexate / Q000008:administration & dosage; D011239:Prednisolone / Q000008:administration & dosage; D013256:Steroids / Q000009:adverse effects
chemical_list: D000951:Antigens, Neoplasm; D018956:CD5 Antigens; D016756:Immunoglobulins, Intravenous; D013256:Steroids; D003561:Cytarabine; D011239:Prednisolone; D008727:Methotrexate