Axonal neuropathy revealing pleural lymphoma as a long-term outcome of therapeutic pneumothorax

• Published in: La revue de medecine interne Vol. 31; no. 8; pp. e3 - e6
• Main Authors: Fajraoui, N, Ben Hamida, K, Hadj Kacem, A, Amouri, R, Ben Ghars, K, Khiari, I, Charfi, M R
• Format: Journal Article
• Language: French
• Published: France 01.08.2010
• Subjects: Aged; Humans; Lymphoma, Large B-Cell, Diffuse - complications; Male; Peripheral Nervous System Diseases - etiology; Pleural Neoplasms - complications; Pneumothorax, Artificial; Time Factors; Treatment Outcome
• ISSN: 1768-3122
• DOI: 10.1016/j.revmed.2009.08.010

Peripheral neuropathy is a rare presenting feature of malignant lymphoma, and commonly associated with diagnostic delay. We report a patient with axonal neuropathy revealing primary pleural lymphoma as a late outcome of pulmonary tuberculosis. A 72-year-old-man with a past medical history of pulmonary tuberculosis presented with a 5-month history of axonal neuropathy. The patient complained of chest pain, altered general status. Chest computed tomography (CT) showed pleural tumour invading the chest wall and CT-guided pleural biopsy revealed a B-cell lymphoma. Chemotherapy was not started in consideration of the poor performance status of the patient. Despite corticosteroids, the peripheral neuropathy worsened and the patient died 2 months after the diagnosis of lymphoma. To our knowledge, no previous case of peripheral neuropathy revealing pleural lymphoma has been reported. The diagnosis of lymphoma must be entertained in the presence of peripheral neuropathy of unknown aetiology. Neuropathy associated to lymphoma results from various mechanisms and is characterised by clinical polymorphism. Their prognosis depends on the mechanism of the neuropathy and the severity of the lymphoma.