Nerve biopsy in T-cell lymphoma with neurolymphomatosis: where and when

Menelaos Pipis; Zane Jaunmuktane; Teresa Marafioti; Sebastian Brandner; Elaine C Smith; Shirley D'Sa; Michael P Lunn; Kate Cwynarski; Doreen Fialho; Sachit Shah; Geraint N Fuller; Mary M Reilly

doi:10.1136/pn-2023-003992

Nerve biopsy in T-cell lymphoma with neurolymphomatosis: where and when

Pract Neurol. 2024 Jan 25:pn-2023-003992. doi: 10.1136/pn-2023-003992. Online ahead of print.

Authors

Menelaos Pipis^{1

2}, Zane Jaunmuktane^{3

4}, Teresa Marafioti⁵, Sebastian Brandner^{3

6}, Elaine C Smith⁷, Shirley D'Sa⁸, Michael P Lunn¹, Kate Cwynarski⁸, Doreen Fialho⁹, Sachit Shah¹⁰, Geraint N Fuller¹¹, Mary M Reilly¹²

Affiliations

¹ Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK.
² Department of Neurology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
³ Department of Neuropathology, The National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, UK.
⁴ Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.
⁵ Department of Histopathology, University College London Hospitals NHS Foundation Trust, London, UK.
⁶ Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK.
⁷ Department of Rheumatology, Cheltenham General Hospital, Cheltenham, UK.
⁸ Department of Clinical Haematology, UCLH NHS Foundation Trust, London, UK.
⁹ Department of Clinical Neurophysiology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
¹⁰ Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, UK.
¹¹ Department of Neurology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.
¹² Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK m.reilly@ucl.ac.uk.

PMID: 38272664
DOI: 10.1136/pn-2023-003992

Abstract

Peripheral T-cell lymphomas are rare heterogeneous haematological malignancies that may also involve peripheral nerves in a very small subset of cases. We report a patient with a diagnostically challenging cutaneous T-cell lymphoma and multifocal mononeuropathies in whom a targeted nerve biopsy identified lymphomatous infiltration of nerves and expedited combination treatment with chemotherapy and an autologous stem cell transplant. She showed an excellent response with a complete metabolic response on positron emission tomography imaging and significant clinical improvement, maintained 5 years post-treatment.

Keywords: CLINICAL NEUROLOGY; HAEMATOLOGY; PERIPHERAL NEUROPATHOLOGY.