弥漫大B细胞淋巴瘤致周围神经病一例  

Diffuse large B-cell lymphoma-associated peripheral neuropathy:a case report

作　　者：杨静 卢燕 尹世敏 Yang Jing;Lu Yan;Yin Shimin(Department of Neurology,the Rocket Army Characteristic Medical Center,Beijing 100088,China)

机构地区：[1]中国人民解放军火箭军特色医学中心神经内科,北京100088

出　　处：《脑与神经疾病杂志》2022年第10期625-630,共6页Journal of Brain and Nervous Diseases

摘　　要：目的 整理1例弥漫大B细胞淋巴瘤致周围神经病变的临床资料,扩展临床医生对周围神经疾病少见病因的诊治思维。方法分析患者病史及在火箭军特色医学中心治疗期间的临床表现、影像学资料和实验室检查。结果初步考虑多神经病变、吉兰-巴雷综合征(Guillain-Barrésyndrome,GBS),应用甲泼尼龙及丙种球蛋白冲击治疗,效果不佳,后经过头颈MRI影像学检查、PET-CT、毒物分析、脑脊液检查等综合诊治,病变组织活检证实弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)。结论淋巴瘤细胞可通过直接浸润或远隔效应引起周围神经病变。Objective The diffuse large B-cell lymphoma can induce peripheral neuropathy.We present the clinical data of one case to expand clinicians’ thinking on the diagnosis of peripheral neuropathy.Methods Aanlyze the patient’s medical history,clinical manifestations,imaging data and laboratory tests during hospitalization.Results The initial diagnosis was given to polyneuropathy or Guillain-Barr é syndrome.The patient underwent therapy with methylprednisolone together with intravenous gamma globulin and without very good response.Finally,the patient was confirmed diffuse large B-cell lymphoma by Tissue biopsy after comprehensive tests such as head and neck MRI.PET-CT toxicology analysis,and cerebrospinal fluid examination.Conclusion Lymphoma cells can cause peripheral neuropathy through direct infiltration or remote effects.Clinicians should raise their awareness of the rare causes of such common diseases.

关 键 词：周围神经疾病 弥漫大B细胞淋巴瘤 吉兰-巴雷综合征 

分 类 号：R247.9[医药卫生—中医临床基础]