Bing-Neel syndrome

Artemiadis, Artemios K; Terentiou, Aspasia; Kolokythopoulos, Dimosthenis; Triantafyllou, Nikos; Nikolaou, George

doi:10.1590/0004-282X20170017

A 75-year-old man with IgM-kappa restricted Waldenström macroglobulinemia (WM) was admitted due to paraparesis and sensory deficits of the lower extremities. Cerebrospinal fluid analysis revealed 140 cells/mm³, increased protein (295mg%), albumin quotient (16.57) and the presence of IgM-kappa chains in immunofixation electrophoresis. Cytology showed lymphoplasmacytoid cells. Magnetic resonance imaging (MRI) demonstrated spinal cord hydromelia and gadolinium-enhancing root lesions (Figure). These findings suggested central nervous system (CNS) involvement of WM or type A Bing-Neel syndrome¹1. Fintelmann F, Forghani R, Schaefer PW, Hochberg EP, Hochberg FH. Bing-Neel Syndrome revisited. Clin Lymphoma Myeloma. 2009;9(1):104-6. https://doi.org/10.3816/CLM.2009.n.028
https://doi.org/10.3816/CLM.2009.n.028... . In Bing-Neel syndrome, MRI usually discloses tumoral or diffuse CNS abnormalities with gadolinium-enhancing leptomeningeal, parenchymal or cranial nerve lesions²2. Malkani RG, Tallman M, Gottardi-Littell N, Karpus W, Marszalek L, Variakojis D et al. Bing-Neel syndrome: an illustrative case and a comprehensive review of the published literature. J Neurooncol. 2010;96(3):301-12. https://doi.org/10.1007/s11060-009-9968-3
https://doi.org/10.1007/s11060-009-9968-... . Chemotherapy (intrathecal methotrexate, rituximab, cyclophosphamide and vincristine) was dispensed with marked clinical improvement.

Figure
Sagittal (A) and axial (B) T2-weighted MRI show marked hydromyelia at T8-T9 level. Axial lumbar T1-weighted with gadolinium MRIs (C,D) show diffuse enhancement of cauda equina’s nerve roots (arrows).

References

¹
Fintelmann F, Forghani R, Schaefer PW, Hochberg EP, Hochberg FH. Bing-Neel Syndrome revisited. Clin Lymphoma Myeloma. 2009;9(1):104-6. https://doi.org/10.3816/CLM.2009.n.028
» https://doi.org/10.3816/CLM.2009.n.028
²
Malkani RG, Tallman M, Gottardi-Littell N, Karpus W, Marszalek L, Variakojis D et al. Bing-Neel syndrome: an illustrative case and a comprehensive review of the published literature. J Neurooncol. 2010;96(3):301-12. https://doi.org/10.1007/s11060-009-9968-3
» https://doi.org/10.1007/s11060-009-9968-3

Erratum

Bing-Neel syndrome.

Arq Neuropsiquiatr 2017;75(4):262. https://doi.org/10.1590/0004-282X20170017

The name of the authors:

Artemiadis K Artemios^1,2, Terentiou Aspasia², Kolokythopoulos Dimosthenis³, Triantafyllou Nikos¹, Nikolaou George²

Should be:

Artemios K. Artemiadis^1,2, Aspasia Terentiou², Dimosthenis Kolokythopoulos³, Nikos Triantafyllou¹, George Nikolaou²

Epidemiological and clinical factors impact on the benefit of riluzole in the survival rates of patients with ALS

Publication Dates

Publication in this collection
Apr 2017

History

Received
18 Aug 2016
Accepted
21 Nov 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

[1] ¹
Fintelmann F, Forghani R, Schaefer PW, Hochberg EP, Hochberg FH. Bing-Neel Syndrome revisited. Clin Lymphoma Myeloma. 2009;9(1):104-6. https://doi.org/10.3816/CLM.2009.n.028
» https://doi.org/10.3816/CLM.2009.n.028

[2] ²
Malkani RG, Tallman M, Gottardi-Littell N, Karpus W, Marszalek L, Variakojis D et al. Bing-Neel syndrome: an illustrative case and a comprehensive review of the published literature. J Neurooncol. 2010;96(3):301-12. https://doi.org/10.1007/s11060-009-9968-3
» https://doi.org/10.1007/s11060-009-9968-3

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