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Journal of the Royal Society of Medicine logoLink to Journal of the Royal Society of Medicine
. 1994 Sep;87(9):526–530. doi: 10.1177/014107689408700915

Effects of lymphoma on the peripheral nervous system.

R A Hughes 1, T Britton 1, M Richards 1
PMCID: PMC1294770  PMID: 7932460

Abstract

Peripheral nervous system abnormalities occur in 5% of patients with lymphoma and have a wide differential diagnosis. Herpes zoster is the commonest cause. Vinca alkaloids are the only drugs used in lymphoma which commonly cause neuropathy. Compression or infiltration of nerve roots by lymphoma is a rare presenting feature but becomes more common with advanced disease. Radiation plexopathy does not usually develop until at least 6 months after irradiation and can be difficult to distinguish from neoplastic infiltration. Either multifocal infiltration of nerves or lymphoma-associated vasculitis may present as a peripheral neuropathy. The incidence of Guillain-Barré (GBS) syndrome, and possibly chronic idiopathic demyelinating polyradiculoneuropathy, appears to be increased in association with lymphoma, especially Hodgkin's disease. Subacute sensory neuronopathy and subacute lower motor neuronopathy have both been reported as paraneoplastic syndromes associated with Hodgkin's disease. Treatment of the underlying lymphoma is only rarely followed by recovery of the associated neuropathy.

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Selected References

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  1. Asbury A. K., Arnason B. G., Adams R. D. The inflammatory lesion in idiopathic polyneuritis. Its role in pathogenesis. Medicine (Baltimore) 1969 May;48(3):173–215. doi: 10.1097/00005792-196905000-00001. [DOI] [PubMed] [Google Scholar]
  2. Borgeat A., De Muralt B., Stalder M. Peripheral neuropathy associated with high-dose Ara-C therapy. Cancer. 1986 Aug 15;58(4):852–854. doi: 10.1002/1097-0142(19860815)58:4<852::aid-cncr2820580408>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
  3. Borit A., Altrocchi P. H. Recurrent polyneuropathy and neurolymphomatosis. Arch Neurol. 1971 Jan;24(1):40–49. doi: 10.1001/archneur.1971.00480310068006. [DOI] [PubMed] [Google Scholar]
  4. Casey E. B., Jellife A. M., Le Quesne P. M., Millett Y. L. Vincristine neuropathy. Clinical and electrophysiological observations. Brain. 1973;96(1):69–86. doi: 10.1093/brain/96.1.69. [DOI] [PubMed] [Google Scholar]
  5. Correale J., Monteverde D. A., Bueri J. A., Reich E. G. Peripheral nervous system and spinal cord involvement in lymphoma. Acta Neurol Scand. 1991 Jan;83(1):45–51. doi: 10.1111/j.1600-0404.1991.tb03957.x. [DOI] [PubMed] [Google Scholar]
  6. Currie S., Henson R. A., Morgan H. G., Poole A. J. The incidence of the non-metastatic neurological syndromes of obscure origin in the reticuloses. Brain. 1970;93(3):629–640. doi: 10.1093/brain/93.3.629. [DOI] [PubMed] [Google Scholar]
  7. Currie S., Henson R. A. Neurological syndromes in the reticuloses. Brain. 1971;94(2):307–320. doi: 10.1093/brain/94.2.307. [DOI] [PubMed] [Google Scholar]
  8. Cuttner J., Meyer R. Guillain-Barré syndrome in a patient with Hodgkin's disease. Mt Sinai J Med. 1978 May-Jun;45(3):415–417. [PubMed] [Google Scholar]
  9. Donaghy M., Hall P., Gawler J., Gregson N. A., Leibowitz S., Jitpimolmard S., King R. H., Thomas P. K. Peripheral neuropathy associated with Castleman's disease. J Neurol Sci. 1989 Feb;89(2-3):253–267. doi: 10.1016/0022-510x(89)90027-0. [DOI] [PubMed] [Google Scholar]
  10. Enevoldson T. P., Ball J. A., McGregor J. M. Resolution of a severe sensorimotor neuropathy following resection of an associated asymptomatic gastric lymphoma. J Neurol Neurosurg Psychiatry. 1990 Mar;53(3):267–268. doi: 10.1136/jnnp.53.3.267. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. England J. D., Asbury A. K., Rhee E. K., Sumner A. J. Lethal retrograde axoplasmic transport of doxorubicin (adriamycin) to motor neurons. A toxic motor neuronopathy. Brain. 1988 Aug;111(Pt 4):915–926. doi: 10.1093/brain/111.4.915. [DOI] [PubMed] [Google Scholar]
  12. Gherardi R., Gaulard P., Prost C., Rocha D., Imbert M., Andre C., Rochant H., Farcet J. P. T-cell lymphoma revealed by a peripheral neuropathy. A report of two cases with an immunohistologic study on lymph node and nerve biopsies. Cancer. 1986 Dec 15;58(12):2710–2716. doi: 10.1002/1097-0142(19861215)58:12<2710::aid-cncr2820581226>3.0.co;2-d. [DOI] [PubMed] [Google Scholar]
  13. Gold J. E., Jimenez E., Zalusky R. Human immunodeficiency virus-related lymphoreticular malignancies and peripheral neurologic disease. A report of four cases. Cancer. 1988 Jun 1;61(11):2318–2324. doi: 10.1002/1097-0142(19880601)61:11<2318::aid-cncr2820611129>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
  14. Haas D. C., Tatum A. H. Plasmapheresis alleviates neuropathy accompanying IgM anti-myelin-associated glycoprotein paraproteinemia. Ann Neurol. 1988 Apr;23(4):394–396. doi: 10.1002/ana.410230415. [DOI] [PubMed] [Google Scholar]
  15. Hammack J., Kotanides H., Rosenblum M. K., Posner J. B. Paraneoplastic cerebellar degeneration. II. Clinical and immunologic findings in 21 patients with Hodgkin's disease. Neurology. 1992 Oct;42(10):1938–1943. doi: 10.1212/wnl.42.10.1938. [DOI] [PubMed] [Google Scholar]
  16. Horwich M. S., Cho L., Porro R. S., Posner J. B. Subacute sensory neuropathy: a remote effect of carcinoma. Ann Neurol. 1977 Jul;2(1):7–19. doi: 10.1002/ana.410020103. [DOI] [PubMed] [Google Scholar]
  17. Ince P. G., Shaw P. J., Fawcett P. R., Bates D. Demyelinating neuropathy due to primary IgM kappa B cell lymphoma of peripheral nerve. Neurology. 1987 Jul;37(7):1231–1235. doi: 10.1212/wnl.37.7.1231. [DOI] [PubMed] [Google Scholar]
  18. Julien J., Vital C., Aupy G., Lagueny A., Darriet D., Brechenmacher C. Guillain-Barré syndrome and Hodgkin's disease--ultrastructural study of a peripheral nerve. J Neurol Sci. 1980 Feb;45(1):23–27. doi: 10.1016/s0022-510x(80)80003-7. [DOI] [PubMed] [Google Scholar]
  19. Kelly J. J., Jr, Kyle R. A., O'Brien P. C., Dyck P. J. Prevalence of monoclonal protein in peripheral neuropathy. Neurology. 1981 Nov;31(11):1480–1483. doi: 10.1212/wnl.31.11.1480. [DOI] [PubMed] [Google Scholar]
  20. Kuroda Y., Nakata H., Kakigi R., Oda K., Shibasaki H., Nakashiro H. Human neurolymphomatosis by adult T-cell leukemia. Neurology. 1989 Jan;39(1):144–146. doi: 10.1212/wnl.39.1.144. [DOI] [PubMed] [Google Scholar]
  21. Lisak R. P., Mitchell M., Zweiman B., Orrechio E., Asbury A. K. Guillain-Barré syndrome and Hodgkin's disease: three cases with immunological studies. Ann Neurol. 1977 Jan;1(1):72–78. doi: 10.1002/ana.410010107. [DOI] [PubMed] [Google Scholar]
  22. McLeod J. G., Penny R. Vincristine neuropathy: an electrophysiological and histological study. J Neurol Neurosurg Psychiatry. 1969 Aug;32(4):297–304. doi: 10.1136/jnnp.32.4.297. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Miralles G. D., O'Fallon J. R., Talley N. J. Plasma-cell dyscrasia with polyneuropathy. The spectrum of POEMS syndrome. N Engl J Med. 1992 Dec 31;327(27):1919–1923. doi: 10.1056/NEJM199212313272705. [DOI] [PubMed] [Google Scholar]
  24. Newman N. J. Multiple cranial neuropathies: presenting signs of systemic lymphoma. Surv Ophthalmol. 1992 Sep-Oct;37(2):125–129. doi: 10.1016/0039-6257(92)90075-5. [DOI] [PubMed] [Google Scholar]
  25. O'Dwyer P. J., Leyland-Jones B., Alonso M. T., Marsoni S., Wittes R. E. Etoposide (VP-16-213). Current status of an active anticancer drug. N Engl J Med. 1985 Mar 14;312(11):692–700. doi: 10.1056/NEJM198503143121106. [DOI] [PubMed] [Google Scholar]
  26. Paul M., Joshua D., Rahme N., Pollard J., Ell J., Gibson J., Bonnet D. Fatal peripheral neuropathy associated with axonal degeneration after high-dose cytosine arabinoside in acute leukaemia. Br J Haematol. 1991 Nov;79(3):521–523. doi: 10.1111/j.1365-2141.1991.tb08067.x. [DOI] [PubMed] [Google Scholar]
  27. Powles R. L., Malpas J. S. Guillain-Barré syndrome associated with chronic lymphatic leukaemia. Br Med J. 1967 Jul 29;3(5560):286–287. doi: 10.1136/bmj.3.5560.286. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Prior R., Schober R., Scharffetter K., Wechsler W. Occlusive microangiopathy by immunoglobulin (IgM-kappa) precipitation: pathogenetic relevance in paraneoplastic cryoglobulinemic neuropathy. Acta Neuropathol. 1992;83(4):423–426. doi: 10.1007/BF00713536. [DOI] [PubMed] [Google Scholar]
  29. Russell J. A., Powles R. L. Letter: neuropathy due to cytosine arabinoside. Br Med J. 1974 Dec 14;4(5945):652–653. doi: 10.1136/bmj.4.5945.652-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Sagar H. J., Read D. J. Subacute sensory neuropathy with remission: an association with lymphoma. J Neurol Neurosurg Psychiatry. 1982 Jan;45(1):83–85. doi: 10.1136/jnnp.45.1.83. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Sahadevan M. G., Raman P. T., Hoon R. S. Landry-Guillain-Barre syndrome complicating lymphosarcoma. A case report. J Assoc Physicians India. 1969 Mar;17(3):215–216. [PubMed] [Google Scholar]
  32. Sandler R. M., Gonsalkorale M. Chronic lymphatic leukaemia, chlorambucil, and sensorimotor peripheral neuropathy. Br Med J. 1977 Nov 12;2(6097):1265–1266. doi: 10.1136/bmj.2.6097.1265-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Schold S. C., Cho E. S., Somasundaram M., Posner J. B. Subacute motor neuronopathy: a remote effect of lymphoma. Ann Neurol. 1979 Mar;5(3):271–287. doi: 10.1002/ana.410050310. [DOI] [PubMed] [Google Scholar]
  34. Sumi S. M., Farrell D. F., Knauss T. A. Lymphoma and leukemia manifested by steroid-responsive polyneuropathy. Arch Neurol. 1983 Sep;40(9):577–582. doi: 10.1001/archneur.1983.04050080077016. [DOI] [PubMed] [Google Scholar]
  35. Vincent D., Dubas F., Hauw J. J., Godeau P., Lhermitte F., Buge A., Castaigne P. Nerve and muscle microvasculitis in peripheral neuropathy: a remote effect of cancer? J Neurol Neurosurg Psychiatry. 1986 Sep;49(9):1007–1010. doi: 10.1136/jnnp.49.9.1007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Vital C., Vital A., Julien J., Rivel J., deMascarel A., Vergier B., Henry P., Barat M., Reiffers J., Broustet A. Peripheral neuropathies and lymphoma without monoclonal gammopathy: a new classification. J Neurol. 1990 Jun;237(3):177–185. doi: 10.1007/BF00314591. [DOI] [PubMed] [Google Scholar]
  37. Weiss H. D., Walker M. D., Wiernik P. H. Neurotoxicity of commonly used antineoplastic agents (first of two parts). N Engl J Med. 1974 Jun 11;291(2):75–81. doi: 10.1056/NEJM197407112910205. [DOI] [PubMed] [Google Scholar]
  38. Willison H. J., Trapp B. D., Bacher J. D., Dalakas M. C., Griffin J. W., Quarles R. H. Demyelination induced by intraneural injection of human antimyelin-associated glycoprotein antibodies. Muscle Nerve. 1988 Nov;11(11):1169–1176. doi: 10.1002/mus.880111111. [DOI] [PubMed] [Google Scholar]
  39. Zuber M., Gherardi R., Imbert M., Gaulard P., Kuentz M., Poirier J. Peripheral neuropathy with distal nerve infiltration revealing a diffuse pleiomorphic malignant lymphoma. J Neurol. 1987 Oct;235(1):61–62. doi: 10.1007/BF00314203. [DOI] [PubMed] [Google Scholar]
  40. van Lieshout J. J., Wieling W., van Montfrans G. A., Settels J. J., Speelman J. D., Endert E., Karemaker J. M. Acute dysautonomia associated with Hodgkin's disease. J Neurol Neurosurg Psychiatry. 1986 Jul;49(7):830–832. doi: 10.1136/jnnp.49.7.830. [DOI] [PMC free article] [PubMed] [Google Scholar]

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