Angiotropic large B-cell lymphoma with clinical features resembling subacute combined degeneration of the cord

Angiotropic large cell lymphoma is a rare neoplastic disorder associated wi th a high mortality. The hallmark of the disease is lymphoid proliferation confined to the intravascular compartment without local tissue or vessel wa ll infiltration [1]. This feature is so striking that the disease was origi nally thought to arise from endothelial tissue and early cases were describ ed as malignant angioendotheliomatosis. However, application of immunohisto chemical methods for detection of lymphoid markers such as the CD45 and CD2 0 cell surface markers has confirmed its lymphoid origin, usually of B-cell lineage [2]. Clinical manifestations of the disease are protean and are du e to multifocal medium and small vessel occlusion by tumour cells [3]. Char acteristic sites of involvement are skin and central nervous system and alt hough an ante-mortem diagnosis can be made from a biopsy specimen, it is of ten unsuspected [4]. We present a case of angiotropic large B-cell lymphoma in a 74-year-old mall who presented with urinary symptoms and had a neurol ogical picture resembling subacute combined degeneration of the cord. (C) 1 999 Elsevier Science B.V. All rights reserved.