Published online Jun 26, 2020. doi: 10.12998/wjcc.v8.i12.2566
Peer-review started: February 24, 2020
First decision: April 24, 2020
Revised: May 20, 2020
Accepted: May 23, 2020
Article in press: May 23, 2020
Published online: June 26, 2020
Lymphoplasmacytic lymphoma is a rare non-Hodgkin’s lymphoma, occurring mostly in the elderly. It develops slowly and leads to malignant proliferation of lymphoid line cells in the bone marrow, lymph nodes and spleen. It may also affect nerve roots and meninges; some patients develop sensorimotor polyneuropathy which may precede general symptoms of lymphoma.
We present a case of a 36-year-old man diagnosed in 2012 with chronic inflammatory demyelinating polyneuropathy (CIDP), then he was hospitalized in 2019 due to progressive symptoms of heart failure and significant weight loss over the previous four months. Based on clinical and laboratory findings a diagnosis of lymphoplasmacytic lymphoma was suspected and confirmed by bone marrow flow cytometry. There was no improvement in the results of laboratory tests and the patient's condition after immediate implementation of chemotherapy. Patient died on the fifth day of treatment.
While CIDP and malignant disease co-occurrence is rare, it should be suspected and investigated in patients with atypical neuropathy symptoms.
Core tip: Lymphoplasmacytic lymphoma is a low-grade B cell type of non-Hodgkin's lymphoma. It occurs mainly in elderly, develops slowly and leads to malignant proliferation of lymphoid line cells in the bone marrow. In some cases, patients develop polyneuropathy, which may precede the general symptoms of lymphoma. We present a case of a young man with chronic inflammatory demyelinating polyneuropathy since 2012. His neurological condition worsened rapidly seven years later, which turned out to be paraneoplastic symptom of aggressive lymphoplasmacytic lymphoma. The lack of typical hematological symptoms resulted in delaying the diagnosis and fatal outcome.