Paraneoplastic neurological syndrome in onset of Hodgkin lymphoma

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Hodgkin lymphoma is a malignant disease with clonal proliferation of B-cells and high-level reactive inflammatory microenvironment. The main clinical sings are lymphadenopathy and toxic symptoms. Neurological symptoms as usual can be a result of compression or tumor infiltration of nervous structures. The primary damage of CNS occurs from 0,2% to 0,5% of all cases HL.

Paraneoplastic neurological syndrome is a group of rare (an average 1 case on 10000 patients) neurological disorders against the background of oncological process. The pathophysiologic mechanism is due to production of antibody which is both to tumor cells and nerve cells. These antibodies are called onconeural autoantibodies. The hallmark which make diagnostics harder is the fact that onconeural autoantibodies rare take place in patients with lymphomas unless anti-Tr and anti-mGluR1 in patients with limbic encephalitis or paraneoplastic cerebellar degeneration.

There are two case reports about patients with PNS in onset of Hodgkin lymphoma in article.

作者简介

Elena Pavlyuchenko

North-Western State Medical University named after I.I. Mechnikov

编辑信件的主要联系方式.
Email: Elena.Pavlyuchenko@szgmu.ru
SPIN 代码: 7123-1626
俄罗斯联邦, 41 Kirochnaya str., Saint Petersburg, 191015

Alexander Mirsaitov

North-Western State Medical University named after I.I. Mechnikov

Email: aleksandr.mirsaitov@gmail.com
SPIN 代码: 7708-5592
俄罗斯联邦, 41 Kirochnaya str., Saint Petersburg, 191015

Mariya Diakonova

North-Western State Medical University named after I.I. Mechnikov

Email: dec.dmn@gmail.com
俄罗斯联邦, 41 Kirochnaya str., Saint Petersburg, 191015

Egor Karev

North-Western State Medical University named after I.I. Mechnikov

Email: Egor.Karev@klinikum-lippe.de
德国, 41 Kirochnaya str., Saint Petersburg, 191015

参考

  1. Rossiiskie klinicheskie rekomendatsii po diagnostike i leche¬niyu limfoproliferativnykh zabolevanii. Ed. by I.V. Poddubnaya, V.G. Savchenko. Moscow: Media Medika; 2013. (In Russ.)
  2. Demina EA. Hodgkin’s lymphoma: since Thomas Hodgkin up to modern days. Clinical Oncohematology. 2008;1(2):114–118. (In Russ.)
  3. Al’-Radi LS, Baryakh EA, Belousova IEh, et al. Klinicheskie rekomendatsii po diagnostike i lecheniyu limfoproliferativnykh zabolevanii. Moscow; 2014. (In Russ.)
  4. Rumyantsev AG, Myakova NV, Maschan AA. Federal guidelines for the diagnosis and treatment of Hodgkin’s lymphoma (Lymphogranulomatosis). Russian Journal of Pediatric Hematology аnd Oncology. 2015;2(4):79–90. (In Russ.). doi: 10.17650/2311-1267-2015-2-4-79-90
  5. Gerstner ER, Abrey LE, Schiff D, et al. CNS Hodgkin lymphoma. Blood. 2008;112(5):1658–1661. doi: 10.1182/blood-2008-04-151563
  6. Valiev TT, Guseva NA, Solozhentseva KD. Clinical profile and differential diagnosis of classical paraneoplastic neurologic syndromes in lymphomas. Onkopediatria. 2017;4(3):183–191. (In Russ.). doi: 10.15690/onco.v4i3.1749
  7. Graus F, Ariño H, Dalmau J. Paraneoplastic neurological syndromes in Hodgkin and non-Hodgkin lymphomas. Blood. 2014;123(21):3230–3238. doi: 10.1182/blood-2014-03-537506
  8. Shnayder NA, Dykhno YuA, Ezhikova VV. Clinical heterogeneity of paraneoplastic neurological syndrome. Siberian Journal of Oncology. 2011;(3):82–90. (In Russ.)
  9. Davydovskaya MV, Boĭko AN, Beliaeva IA, et al. Autoimmune encephalitis. S.S. Korsakov Journal of Neurology and Psychiatry. 2015;115(4):95–101. (In Russ.). doi: 10.17116/jnevro20151154195-101
  10. Tandra PK, Kallam A, Bendi VS, et al. Paraneoplastic manifestations of lymphoproliferative neoplasms. Lymphoma and Chronic Lymphocytic Leukemias. 2016;(6):21–33. doi: 10.4137/LCLL.S38507
  11. Krasnov MYu, Pavlov EV, Ershova MV, et al. The range of neurological syndromes associated with glutamic acid decar¬boxylase antibodies. Annals of Clinical and Experimental Neurology. 2015;9(4):37–41. (In Russ.)

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2. Fig. 1. Magnetic resonance tomography — diffuse changes in brain substance with features of active pathological process: a — axial section, convexital surface; b — axial section, level of basal nuclei (diffuse changes in the structure of the cerebellar stalks); c — frontal section (focal areas of accumulation of contrast agent in the right frontal lobe); d — axial section, convexital surface (focal areas of accumulation of contrast material in the right frontal lobe)

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3. Fig. 2. Magnetic resonance tomography — diffuse changes in brain substance without features of active pathological process: a — axial section at the level of the lateral ventricles; b — axial section at the level of the anterior horns; c — axial section, the level of the posterior horns of the lateral ventricles; d — axial section, convexital surface

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版权所有 © Pavlyuchenko E., Mirsaitov A., Diakonova M., Karev E., 2021

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