Paraneoplastic autoimmune encephalitis associated with pleomorphic lung carcinoma: An autopsy case report

Ando, Takashi; Goto, Yoji; Mano, Kazuo; Nomura, Fumio; Kurashige, Masako; Ito, Masafumi; Mimuro, Maya; Iwasaki, Yasushi; Katsuno, Masahisa; Yoshida, Mari

doi:10.1111/neup.12477

Cited by 3 publications

(1 citation statement)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An autopsy was performed three hours after death. Tissue preparation, trimming, routine staining, and immunohistochemistry were carried out as previously described 7,8 . Briefly, the tissues were fixed in 20% formalin for four weeks.…”

Section: Pathological Findingsmentioning

confidence: 99%

Neurolymphomatosis in follicular lymphoma: an autopsy case report

et al. 2022

Self Cite

View full text Add to dashboard Cite

Neurolymphomatosis is a neurological manifestation of lymphoma that involves the cranial or spinal peripheral nerves, nerve roots, and plexus with direct invasion of neoplastic cells. Neurolymphomatosis is rare among patients with low‐grade lymphoma. We report an autopsied case of neurolymphomatosis that arose from follicular lymphoma. A 49‐year‐old woman who presented with pain of her neck and shoulder and numbness of her chin. Computed tomography revealed enlarged lymph nodes in her whole body, and biopsy from the axillary lymph node revealed grade 2 follicular lymphoma. Although the patient underwent chemotherapy, she gradually developed muscle weakness in the upper limbs and sensory disturbances of the trunk and limbs. 18F‐fluorodeoxyglucose positron emission tomography (FDG‐PET) revealed increased tracer uptake of the cervical nerve roots. Repeated FDG‐PET after additional therapy revealed progression of disease within the nerve roots and brachial plexus, whereas gadolinium‐contrast magnetic resonance imaging (MRI) showed weak enhancement of the cervical nerve roots without formation of mass lesions. She died after a total disease duration of 12 months. Postmortem observations revealed invasion of lymphoma cells into the cervical nerve roots, dorsal root ganglia, and subarachnoid spaces of the spinal cord. Neurolymphomatosis was prominent at the segments of C6–Th2. Combined loss of axons and myelin sheaths was observed in the cervical nerve roots and posterior columns. Lymphoma cells also invaded the cranial nerves. The subarachnoid and perivascular spaces of the brain demonstrated focal invasion of the lymphoma. Mass lesions were not observed in the central nervous system. The lymphoma cells did not show histological transformation to higher grades, and the density of the centroblasts remained at grade 2. Our report clarifies that low‐grade follicular lymphoma can manifest as neurolymphomatosis and central nervous system invasion in the absence of transformation toward higher histological grades. FDG‐PET may be more sensitive to non‐mass‐forming lesions, including neurolymphomatosis, than gadolinium‐contrast MRI.

show abstract

Section: Pathological Findingsmentioning

confidence: 99%

Neurolymphomatosis in follicular lymphoma: an autopsy case report

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

Mental disorder or conscious disturbance in epidermal growth factor receptor-tyrosine kinase inhibitor treatment of advanced lung adenocarcinoma

Zhu

Zhou

Xiao

2020

EXCLI Journal; 19:Doc230; ISSN 1611-2156

View full text Add to dashboard Cite

Pulmonary Pleomorphic Carcinoma Mimicking Primary Sarcoma of the Neck: A Case Report and Literature Review

Ogawa¹,

Arahata

Kuriyama³

et al. 2021

CIA

View full text Add to dashboard Cite

We describe our challenge in diagnosing an unusual and rapidly progressing case of pulmonary pleomorphic carcinoma (PPC)—a rare, poorly differentiated, or undifferentiated non-small-cell carcinoma that can metastasize locally or distantly and has a poor prognosis. Our patient was an elderly man with a one-month history of abdominal pain, anorexia, and weight loss, diagnosed with atrophic gastritis via endoscopy, and treated medically without improvement. A week later, this patient developed pain in the head, neck, and shoulder area, and further examination revealed a thickening of his left neck and shoulder, with no palpable lymph nodes. Computed tomography (CT) of the neck, chest, and abdomen led us to believe that we might be dealing with primary sarcoma of the neck since no lung mass was evident. Further investigation could not be performed because the patient’s status deteriorated rapidly. An autopsy revealed that soft tissue in the left neck and the mesentery was invaded by poorly differentiated polymorphic malignant cells, which were also seen in the lung lesion. Immunohistochemically, these malignant cells were all positive for AE1/AE3, CAM5.2, TTF-1, Napsin-A, and Vimentin. The cells were also positive for programmed death-ligand 1 staining with a low level of tumor proportion score (over 1%). The final diagnosis was PPC with metastases to soft tissues in the left neck and the mesentery. A review of previous case reports of PPC revealed that soft tissue is an uncommon site for metastasis, and that our CT findings were rather unusual. We hereby present our case and review of published case reports, with the hope that an awareness of the heterogeneous features of PPC could prompt timely biopsy and histological diagnosis.

show abstract

Paraneoplastic autoimmune encephalitis associated with pleomorphic lung carcinoma: An autopsy case report

Cited by 3 publications

References 24 publications

Neurolymphomatosis in follicular lymphoma: an autopsy case report

Neurolymphomatosis in follicular lymphoma: an autopsy case report

Mental disorder or conscious disturbance in epidermal growth factor receptor-tyrosine kinase inhibitor treatment of advanced lung adenocarcinoma

Pulmonary Pleomorphic Carcinoma Mimicking Primary Sarcoma of the Neck: A Case Report and Literature Review

Contact Info

Product

Resources

About