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Neurologic complications of lymphomatoid granulomatosis

Neurology Service, Department of Medicine, Letterman Army Medical Center, Presidio of San Francisco, CA.

Lymphomatoid granulomatosis is a malignant form of pulmonary angiitis that has characteristics in common with Wegener granulomatosis and lymphoma. Neurologic symptoms occur in up to 30% of the cases and are the presenting complaints in up to 21%. CNS, cranial nerve, and peripheral nerve involvement occur singly or in combination. In the CNS there is a pathologic triad of angiitis, lymphoreticular infiltration, and necrosis. In the involved peripheral nerves there is demyelination and lymphoid cell infiltration. Neurologic involvement tends to indicate a worse prognosis. Treatment has been based on steroids and cytotoxic agents and may improve symptoms but does not seem to alter the disease process.

Address correspondence to Dr. Hogan, Letterman Army Medical Center, Presidio of San Francisco, CA 94129.

Address reprint requests to Technical Publications Editor, Letterman Army Medical Center, Presidio of San Francisco, CA 94129.

Accepted for publication July 29, 1980.