Presentation of intravascular lymphomatosis as lumbosacral polyradiculopathy

A 53-year-old man developed progressive sensory disturbance and weakness in the legs, sphincter disturbance, back pain, systemic symptoms, and pancyto penia. Electrophysiological tests indicated a widespread lumbosacral polyra diculopathy. Spinal magnetic resonance imaging and routine cerebrospinal fl uid analysis showed minor nonspecific abnormalities. Bone marrow and liver biopsies showed hemophagocytosis; and polymerase chain reaction of cerebros pinal fluid, bone marrow, and serum suggested active infection with human h erpesvirus-6. Autopsy revealed that his neurological symptoms resulted from intravascular lymphomatosis (angiotropic large cell lymphoma), a rare vari ant of lymphoma with predilection for the nervous system. (C) 2000 John Wil ey & Sons, Inc.