02174nas a2200241   4500000000100000008004100001653002100042653002700063653002300090653007400113100001300187700001500200700001300215700001600228700001900244700001200263245012400275856005800399300001200457490000700469520144200476022001401918       2017                            d10aHansen's disease10aFine needle aspiration10aNeurolymphomatosis10aPrimary cutaneous CD4+ pleomorphic small/medium-sized T-cell lymphoma1 aKhader A1 aVineetha M1 aGeorge M1 aManakkad SP1 aBalakrishnan S1 aRajan U00aNeurolymphomatosis in Primary Cutaneous CD4+ Pleomorphic Small/Medium-sized T-cell Lymphoma Mimicking Hansen's Disease.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5448269/  a315-3170 v623 a<p>Neurolymphomatosis (NL) refers to nerve infiltration by neurotropic neoplastic cells in the setting of a known or an unknown hematological malignancy. It typically presents as painful or painless peripheral mononeuropathy, mononeuritis multiplex, polyneuropathy, polyradiculopathy, or cranial neuropathy. A 32-year-old male presented with a hyperpigmented hypoesthetic plaque over the anterolateral aspect of the right leg with thickening of the right common peroneal nerve and foot drop clinically diagnosed as Hansen's disease. Biopsy taken from skin showed infiltrates of pleomorphic small and medium sized lymphocytes in the dermis and subcutis. On immunohistochemistry, the cells were positive for CD3, CD4 and negative for CD8, CD20, and CD30. Ultrasonography-guided fine-needle aspiration of the thickened nerve showed infiltrates of atypical lymphoid cells. Based on these findings, a diagnosis of NL in primary cutaneous CD4+ pleomorphic small/medium-sized T-cell lymphoma was made. The disease responded to systemic chemotherapy and localized radiotherapy with no evidence of relapse during 3 years follow-up. NL in primary cutaneous CD4+ pleomorphic small/medium-sized T-cell lymphoma presenting with manifestations redolent of Hansen's disease is not described in available literature. This case also demonstrates the utility of fine needle aspiration of nerve, a minimally invasive procedure in the diagnosis of NL.</p>
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