A rare case report of neurolymphomatosis with NK-T-cell lymphoma

Abstract

Neurolymphomatosis (NL) is a rare entity. It is usually a manifestation of B-cell lymphoma. Here we describe a case of neurolymphomatosis in a 72 year old man who was in remission for Nasal T-cell lymphoma and presented to us with subacute onset painful mononeuritis like weakness involving all 4 limbs sequentially over a period of 4 months. he was initially treated as CIDP with steroids but later in view of progression he was evaluated further. His FDG PET-CT showed increased uptake in left brachial plexus which was confirmed by subsequent MRI neurography. He underwent biopsy of left brachial plexus and diagnosis of neurolymphomatosis was confirmed. He was treated with intravenous immunoglobulins (2 gm/kg) over 5 days with minimal improvement in his neurological symptoms, his shoulder pain improved and he could feed himself with right hand. He was offered palliative treatment in view of poor prognosis seen in neurolymphomatosis. He succumbed to the illness 3 months later.