An Unexpected Cause of Tetraparesis – Clinical Case

Abstract

The authors report a clinical case of an 83-year-old-woman who was attended the Emergency Service for decreased
strength in her limbs. The physical examination presented tetraparesis, with muscle strength grade 1/5 in the lower limbs, grade 3/5 in the upper limbs and absent deep tendon reflexes.
The lumbar puncture showed albuminocytologic dissociation.
It was assumed a diagnosis of Guillain-Barre syndrome and
immunoglobulins were started. Progressive clinical deterioration with respiratory failure and need of non-invasive ventilation
have followed. Palpable abdominal mass, leading to an abdominal CT scan showed multiple nodules of peritoneal surfaces,
large mass with 13 cm diameter and multiple enlarged lymph nodes. Biopsy of abdominal mass histology compatible with
centroblastic variant of diffuse large B-cell lymphoma. Started corticosteroid therapy, with unfavorable clinical course, and the
patient died. The authors report this case due to rare form the lymphoma was presented