title: Value of nerve biopsy in patients with latent malignant hemopathy and peripheral neuropathy: a case series.
abstract: Hematological malignancies include several diseases that may affect the peripheral nervous system (PNS) through various mechanisms. A common and challenging situation is represented by the occurrence of an active peripheral neuropathy in a patient with a supposed inactive hematological disorder.We report clinical, electrophysiological, biological, and pathological data of 8 patients with latent malignant hemopathies (most were considered in remission): B-cell chronic lymphocytic leukemia in 3 patients, B-cell lymphoma in 1 patient, low-grade non-Hodgkin's lymphoma in 1 patient, Waldenström's macroglobulinemia in 1 patient, smoldering multiple myeloma in 1 patient, and monoclonal gammopathy of undetermined significance in 1 patient.In all these cases, the nerve biopsy (NB) helped to diagnose the hematological relapse or detect a pathological mechanism linked to the hematological disorder: epineurial lymphocytic infiltration in 5 patients (including one with antimyelin-associated glycoprotein antibodies), cryoglobulin deposits in 1 patient, chronic inflammatory demyelinating polyneuropathy in 1 patient, and necrotizing vasculitis in 1 patient. In each case, pathological findings were crucial to select the adequate treatment, leading to an improvement in the neurological and biological manifestations.These observations illustrate the value of NB and the need for active collaboration between neurologists and hematologists in such cases.
authors.affiliation: From the Department of Pathology (MD); Department of Neurology, CHU Poitiers, University of Poitiers, Poitiers (SM); Department of Neurology, CHU Tours, Tours (PC); Department of Hematology, CHU Limoges (AJ); and Department of Neurology and Centre de Référence "Neuropathies périphériques rares", CHU Limoges, Limoges, France (JMV).
authors.forename: Mathilde
authors.initials: M
authors.lastname: Duchesne
authors.forename: Stéphane
authors.initials: S
authors.lastname: Mathis
authors.forename: Philippe
authors.initials: P
authors.lastname: Corcia
authors.forename: Laurence
authors.initials: L
authors.lastname: Richard
authors.forename: Karima
authors.initials: K
authors.lastname: Ghorab
authors.forename: Arnaud
authors.initials: A
authors.lastname: Jaccard
authors.forename: Laurent
authors.initials: L
authors.lastname: Magy
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Vallat
mesh_terms: D000368:Aged; D001706:Biopsy; D019468:Disease Management; D005260:Female; D019337:Hematologic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010525:Peripheral Nerves / Q000473:pathology*; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000473:pathology