GANGLIONITIS IN PARANEOPLASTIC SUBACUTE SENSORY NEURONOPATHY - A MORPHOLOGIC STUDY

A 69-year-old woman presented with subacute sensory neuropathy and aut onomic dysfunction of 9 months' duration, associated with high serum t iters of anti-Hu antibodies. A small cell carcinoma of the lung was di agnosed by biopsy. She died after cardiorespiratory arrest. At autopsy , spinal and autonomic ganglia showed subacute inflammation with diffu se endoneurial T-cell, B-cell, and plasma cell infiltration. The cytop lasm and nuclei of some ganglion neurons displayed IgG immunocytochemi cal positivity. CD8+ T cells were tightly attached to, and indented th e cell surface of, IgG-positive and IgG-negative neurons. This observa tion suggests that both cytotoxic T-cell-mediated attack against neuro ns and humoral mechanisms play a role in paraneoplastic subacute senso ry neuronopathy.