REVIEW
Peripheral nervous system involvement in lymphomas
Chiara Briani,
Andrea Visentin,
Marta Campagnolo,
Alessandro Salvalaggio,
Sergio Ferrari,
Tiziana Cavallaro,
Renzo Manara,
Roberto Gasparotti,
Francesco Piazza,
Corresponding Author
Chiara Briani
Department of Neuroscience, University of Padova, Padova, Italy
Correspondence
Chiara Briani, MD, Department of Neurosciences, University of Padova, Via Giustiniani, 5, 35128 Padova, Italy.
Email: [email protected]
Search for more papers by this authorAndrea Visentin
Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Padova, Italy
Search for more papers by this authorMarta Campagnolo
Department of Neuroscience, University of Padova, Padova, Italy
Search for more papers by this authorAlessandro Salvalaggio
Department of Neuroscience, University of Padova, Padova, Italy
Search for more papers by this authorSergio Ferrari
Department of Neurology, Azienda Ospedaliera Universitaria Integrata, University Hospital G.B. Rossi, Verona, Italy
Search for more papers by this authorTiziana Cavallaro
Department of Neurology, Azienda Ospedaliera Universitaria Integrata, University Hospital G.B. Rossi, Verona, Italy
Search for more papers by this authorRenzo Manara
Neuroradiology, Department of Medicine and Surgery, University of Salerno, Fisciano, Italy
Search for more papers by this authorRoberto Gasparotti
Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
Search for more papers by this authorFrancesco Piazza
Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Padova, Italy
Search for more papers by this authorChiara Briani,
Andrea Visentin,
Marta Campagnolo,
Alessandro Salvalaggio,
Sergio Ferrari,
Tiziana Cavallaro,
Renzo Manara,
Roberto Gasparotti,
Francesco Piazza,
Corresponding Author
Chiara Briani
Department of Neuroscience, University of Padova, Padova, Italy
Correspondence
Chiara Briani, MD, Department of Neurosciences, University of Padova, Via Giustiniani, 5, 35128 Padova, Italy.
Email: [email protected]
Search for more papers by this authorAndrea Visentin
Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Padova, Italy
Search for more papers by this authorMarta Campagnolo
Department of Neuroscience, University of Padova, Padova, Italy
Search for more papers by this authorAlessandro Salvalaggio
Department of Neuroscience, University of Padova, Padova, Italy
Search for more papers by this authorSergio Ferrari
Department of Neurology, Azienda Ospedaliera Universitaria Integrata, University Hospital G.B. Rossi, Verona, Italy
Search for more papers by this authorTiziana Cavallaro
Department of Neurology, Azienda Ospedaliera Universitaria Integrata, University Hospital G.B. Rossi, Verona, Italy
Search for more papers by this authorRenzo Manara
Neuroradiology, Department of Medicine and Surgery, University of Salerno, Fisciano, Italy
Search for more papers by this authorRoberto Gasparotti
Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
Search for more papers by this authorFrancesco Piazza
Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Padova, Italy
Search for more papers by this authorAbstract
The peripheral nervous system may be involved at any stage in the course of lymphoproliferative diseases. The different underlying mechanisms include neurotoxicity secondary to chemotherapy, direct nerve infiltration (neurolymphomatosis), infections, immune-mediated, paraneoplastic or metabolic processes and nutritional deficiencies. Accordingly, the clinical features are heterogeneous and depend on the localization of the damage (ganglia, roots, plexi, and peripheral nerves) and on the involved structures (myelin, axon, and cell body). Some clinical findings, such a focal or diffuse involvement, symmetric or asymmetric pattern, presence of pain may point to the correct diagnosis. Besides a thorough medical history and neurological examination, neurophysiological studies, cerebrospinal fluid analysis, nerve biopsy (in selected patients with suspected lymphomatous infiltration) and neuroimaging techniques (magnetic resonance neurography and nerve ultrasound) may be crucial for a proper diagnostic workup.
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