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Demyelinating neuropathy due to primary IgM kappa B cell lymphoma of peripheral nerve

Departments of Neurology and Histopathology, University of Newcastle upon Tyne, UK.

A 53-year-old man presented with a painful, demyelinating sensorimotor peripheral neuropathy with lymphomatous infiltration on sural nerve biopsy, but no evidence of systemic lymphoma. The neuropathy responded to cytotoxic therapy. Seven years later he developed generalized lymphadenopathy due to B cell lymphoplasmacytoid lymphoma, with a subpopulation of cells expressing a monoclonal pattern of IgM k. The lymphomatous infiltrate in the original nerve biopsy showed similar monoclonal IgM k reactivity. The mechanism of demyelination of the peripheral nerves may be similar to that described in patients with IgM k monoclonal gammopathies.

Address correspondence and reprint requests to Dr. Ince, Department of Histopathology, Royal Victoria Infirmary, Newcastle-upon-Tyne NE1 4LP, UK.

Received May 28, 1986. Accepted for publication in final form October 14, 1986.

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