Neurolymphomatosis presenting as mononeuritis multiplex

We report the case of a 60-year-old man who presented with a mononeuritis m ultiplex-type illness, beginning cranially and then sequentially involving peripheral nerves in all four limbs and torso, Despite extensive investigat ion, including multiple lumbar punctures and tissue biopsies, the diagnosis was not made until his death 10 months after presentation. Post mortem rev ealed lymphocytic infiltration of multiple peripheral nerves and radicules with minimal central nervous system involvement, consistent with neurolymph omatosis. Except for the pericardium, there was no other evidence of system ic lymphoma. Recent similar case reports highlight the value of magnetic re sonance imaging of plexi and peripheral nerves, which may increase the chan ce of an antemortem diagnosis in this typically elusive disorder. (C) 1999 Harcourt Publishers Ltd.