Negative sural nerve biopsy in neurolymphomatosis

J Neurol. 1999 Dec;246(12):1159-63. doi: 10.1007/s004150050535.

Abstract

Patients with non-Hodgkin's lymphoma occasionally develop widespread invasion of peripheral nerves by tumor cells or neurolymphomatosis (NL). Clinically this usually results in asymmetrical, progressive, and painful polyneuropathy. Diagnosis rests on the identification of tumor cells in peripheral nerves. To avoid false-negative biopsy findings in patients with malignant lymphomatous infiltration of peripheral nerves it has been recommended to biopsy clinically involved nerves. We present two patients with histologically confirmed NL in whom sural the nerve biopsy finding was negative despite clinical and neurophysiological evidence of involvement of the sural nerve a. The clinical features of NL are reviewed. Some patients with neurolyphomatosis have only focal or proximal involvement of nerves, requiring the biopsy of an affected part of these nerves. Magnetic resonance imaging may be useful in identifying affected nerves.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Biopsy
  • Humans
  • Lymphoma, Non-Hodgkin / diagnosis
  • Lymphoma, Non-Hodgkin / pathology*
  • Lymphoma, Non-Hodgkin / physiopathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neoplasm Invasiveness / diagnosis
  • Neoplasm Invasiveness / pathology
  • Neoplasm Invasiveness / physiopathology
  • Peripheral Nerves / pathology*
  • Peripheral Nerves / physiopathology
  • Sural Nerve / pathology*
  • Sural Nerve / physiopathology