title: [A case of neurolymphomatosis presenting extended involvement of spinal nerve roots].
abstract: A 56-year-old man suffered from diffuse large B-cell lymphoma (DLBCL) originated from the stomach. He received R-CHOP therapy, and had a complete remission. However, at age 57, he experienced left shoulder pain and weakness of left arm, and his muscle weakness and sensory disturbance subacutely progressed to other limbs. Cervical and lumbosacral MRI showed enhanced extended lesions of cervical, thoracic, lumbar, and sacral nerve roots and cauda equina. Cerebrospinal fluid analysis revealed a sustained low glucose level. Nerve conduction study showed abnormalities of measurement parameters of F-waves in all limbs. A diagnosis of recurrent DLBCL presenting neurolymphomatosis could be established by repeated cytology of cerebrospinal fluid. He received high dose methotrexate therapy, but his symptoms were worsened to tetraplegia. It should be noticed that DLBCL can involve spinal nerve roots extensively.
authors.affiliation: Department of Neurology, Gunma University Graduate School of Medicine.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sato
authors.forename: Minori
authors.initials: M
authors.lastname: Furuta
authors.forename: Kimitoshi
authors.initials: K
authors.lastname: Hirayanagi
authors.forename: Shun
authors.initials: S
authors.lastname: Nagamine
authors.forename: Kouki
authors.initials: K
authors.lastname: Makioka
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ikeda
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D002555:Cerebrospinal Fluid / Q000166:cytology; D003520:Cyclophosphamide / Q000008:administration & dosage; D003581:Cytodiagnosis; D018450:Disease Progression; D004317:Doxorubicin / Q000008:administration & dosage; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D011782:Quadriplegia / Q000209:etiology; D012074:Remission Induction; D000069283:Rituximab; D013126:Spinal Nerve Roots / Q000473:pathology*; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone; D008727:Methotrexate