J Korean Med Sci.  2004 Feb;19(1):130-133. 10.3346/jkms.2004.19.1.130.

A Case of Hodgkin's Lymphoma Associated with Sensory Neuropathy

• Oh BC
• Lim YM
• Kwon YM
• Khang SK
• Kim KK

• KMID: 1785707
• DOI: http://doi.org/10.3346/jkms.2004.19.1.130

Abstract

Peripheral neuropathies occur in lymphoma patients. Causes of neuropathy include chemotherapy, opportunistic infections, and the lymphoma itself. We report a patient with lymphoma whose chief complaint was a sensory loss in the hands and feet. Electrophysiologic studies and sural nerve biopsy showed sensory polyneuropathies. We hypothesize that this neuropathy is associated with lymphoma-related ganglionopathy, and among the possible causes, we suspect that a systemic cause such as a paraneoplastic syndrome is the most likely pathogenic etiology. However, further follow-up will be necessary to see whether sensory symptoms change with lymphoma treatment.

Keyword

Lymphoma; Polyneuropathies; Paraneoplastic Syndromes

MeSH Terms

Adult
Biopsy
Electrophysiology
Hodgkin Disease/*complications/*diagnosis
Human
Lymphatic Metastasis
Lymphoma/*metabolism
Male
Peripheral Nervous System Diseases/*complications/*pathology
Sensation Disorders/complications/pathology

Figure

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  Fig. 1 Lymph node biopsy (H&E stain, ×20). Microscopically, the mass exhibits diffuse effacement of lymph node architecture and granulomas. Inset is the enlarged picture (×200) of the area indicated by arrow.

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  Fig. 2 Lymph node biopsy (H&E stain, ×200). Reed-Sternberg cells (solid arrow) are scattered among a background of many mature lympocytes. Arrow inside inset shows mitosis.

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  Fig. 3 Sural nerve biopsy (modified Gomori trichrome stain, ×100). The sural nerve biopsy shows several myelin digestion chambers (arrow), suggesting axonal degeneration.

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  Fig. 4 Sural nerve biopsy (EM findings, ×7,000). The sural nerve shows loss of small and large myelinated fibers and degenerating axons with myelin ovoids (arrow), suggesting axonal neuropathy.

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