Shams Raza Brohi.
Neurolymphomatosis of Peroneal Nerve.
J Coll Physicians Surg Pak Jan ;9(4):199-200.

Neurolymphomatosis of peripheral nerves as an isolated case or extranodal manifestation of lymphoma is very rare. We are presenting here a case of non-Hodgkin`s malignant lymphoma (NHML) of B-cell type of peroneal nerve.

CASE REPORTS: A 48 year old man presented with pain in right foot and gradual foot drop over a period of six months. On examination he had power of grade 0 in dorsifexors; and hypoesthesia over dorsum and lateral surface of leg. In popliteal fossa,he had a firm, non tender, non fluctuant, non pulsatile swelling which was mobile in horizontal direction. Skin overlying the swelling was free and there was paraesthesia over the distribution of right peroneal nerve (Tinel`s sign was positive). Sedimentation rate, blood count and blood chemistry were normal. Chest X-ray was within normal limits. Ultrasound examination of abdomen did not reveal any abnormality. Bone marrow examination showed no infiltration. Nerve conduction studies showed decreased velocity in right peroneal nerve. A clinical impression of peroneal neurofibroma was made. On surgical exploration it was found that tumour was confined to peroneal nerve distribution extending from mid thigh upto head of fibula. Tibial nerve was spared. There was no perineural invasion. It was completely excised. Histopathological examination confirmed it to be nonHodgkin`s lymphoma (mixed small and large cell type) intermediate grade of B-cell original according to new working formulation. It was staged as I.E. Postoperatively patient remained well with same neurologic deficit. He was referred for chemotherapy. He had no recurrence after 3 months follow-up.

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