Paraneoplastic cerebellar degeneration in a patient with anaplastic non-Hodgkin's lymphoma

BMJ Case Rep. 2018 Jun 15:2018:bcr2017224100. doi: 10.1136/bcr-2017-224100.

Abstract

A 31-year-old man presented with a subacute cerebellar syndrome of unknown aetiology. Investigations including a paraneoplastic antibody screen were negative and a working diagnosis of possible vasculitis was concluded. After 1 month, he re-presented with worsening of his symptoms and a neck lump. He was diagnosed with anaplastic lymphoma kinase, negative non-Hodgkin's lymphoma and paraneoplastic cerebellar syndrome. A more extensive paraneoplastic antibody screen found patient to be Tr (delta/notch-like epidermal growth factor-related receptor) antibody positive. After a period of chemotherapy and steroid treatments, his symptoms are now stable in terms of cerebellar function. This case report summarises a very rare diagnosis of paraneoplastic cerebellar degeneration with a positive onconeuronal antibody associated with anaplastic non-Hodgkin's lymphoma.

Keywords: brain stem / cerebellum; neurology; neurooncology; radiology.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anaplastic Lymphoma Kinase
  • Antineoplastic Agents / therapeutic use
  • Diagnosis, Differential
  • Drug Therapy
  • Humans
  • Lymphoma, Non-Hodgkin / diagnosis*
  • Lymphoma, Non-Hodgkin / drug therapy*
  • Lymphoma, Non-Hodgkin / metabolism
  • Male
  • Paraneoplastic Cerebellar Degeneration / drug therapy*
  • Paraneoplastic Cerebellar Degeneration / etiology*
  • Receptor Protein-Tyrosine Kinases / metabolism
  • Steroids / therapeutic use
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Steroids
  • ALK protein, human
  • Anaplastic Lymphoma Kinase
  • Receptor Protein-Tyrosine Kinases