Fulminant leukemic polyradiculoneuropathy in a case of B-cell prolymphocytic leukemia: a clinicopathologic report

A 52 year old man with a 10-month history of &cell prolymphocytic leukemia (PLL) died of an apparent acute fulminant polyradiculoneuropathy, a condition generally attributed to paraneoplastic complication. The pathologic examination disclosed diffuse leukemic infiltrations of the peripheral nervous system. It is suggested that this particularly aggressive form of B-cell chronic prolymphocytic leukemia presented a constellation of features that promoted the invasion of the peripheral nervous system by way of the bloodstream and may explain the unusual clinical presentation. Cancer 60:1454-1458,1987. ERIPHERAL NERVOUS SYSTEM (PNS) complications P occur in about two percent of patients with chronic lymphocytic leukemias (CLL).'.' These complications may result from leukemic infiltrations or may be paraneoplastic. We describe diffuse leukemic infiltrations of the PNS in a patient with B-cell PLL who died of an apparent acute fulminant polyradiculoneuropathy, a condition generally attributed to a paraneoplastic compli~ation.~-~ We are not aware that a similar clinicopathologic case has been reported in association with B-cell PLL.