|
|
|
|
Neurological manifestations are primarily caused by varying degrees of ischemia due to intravascular tumor cells. These symptoms are usually subacute in onset and have a progressive course: They include, in the order of frequency, 1) multiple cerebral infarcts, 2) disorders of lumbosacral cord and its nerve roots accompanied by paraparesis, 3) subacute encephalopathy, and 4) mononeuropathy and multiple mononeuropathy that include cranial nerves. The most important diagnostic finding in IML is the histological demonstration of tumor cells within small vessel lumina. Although the antemortem diagnosis of IML has been difficult, the results of recent studies involving random skin biopsy are promising for such a diagnosis. Since the recent addition of rituximab to CHOP therapy has proven to markedly improve the prognosis of IML. We should therefore try to avoid overlooking this treatable disease. |
|