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- W137472762 abstract "Les neuropathies périphériques peuvent rarement constituer une manifestation inaugurale des lymphomes malins et poser des difficultés diagnostiques. Nous rapportons une observation de neuropathie axonale révélant un lymphome pleural primitif, sur séquelles de tuberculose. Un homme de 72 ans, aux antécédents de tuberculose pulmonaire avec séquelles pleuroparenchymateuses, présentait une mononeuropathie multiple de type axonal des quatre membres évoluant depuis cinq mois, puis des douleurs de la base thoracique droite évoluant dans un contexte d’altération de l’état général. La tomodensitométrie thoracique révélait une tumeur pleurale envahissant la paroi thoracique ; la biopsie de la masse mettait en évidence un lymphome B à grandes cellules. L’état général du malade ne permettait pas l’instauration d’une chimiothérapie. Les manifestations neurologiques s’aggravaient sous corticothérapie et le patient décédait deux mois après le diagnostic de lymphome pleural. Le lymphome pleural sur séquelle de tuberculose est une entité rare ; sa révélation par une neuropathie périphérique n’a pas été rapportée auparavant. Les neuropathies associées aux lymphomes relèvent de divers mécanismes et se caractérisent par leur polymorphisme clinique ; leur pronostic dépend du mécanisme de la neuropathie et de l’agressivité du lymphome.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." @default.
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- W137472762 date "2005-11-01" @default.
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- W137472762 title "Mononeuropathie multiple révélant un lymphome T" @default.
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- W137472762 doi "https://doi.org/10.1016/j.revmed.2005.05.011" @default.
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