Peripheral neuropathy simulating lymphoma

Nerve hypertrophy occurs in some types of Charcot-Marie-Tooth syndrome (hereditary motor and sensory neuropathy (HMSN) type I), Dejerine-Sottas disease (HMSN type III), Refsum's disease (HMSN type IV), neurofibromatosis, amyloidosis, sarcoidosis, leprosy, diabetes mellitus, chronic relapsing neuropathies, acromegaly, hypothyroidism, isolated peripheral nerve lesions and, very rarely, multiple sclerosis (Dyck, 1984; Walton, 1985). We report a case of HMSN type I with marked intercostal, splanchnic and peripheral nerve hypertrophy producing radiological appearances of pleural lesions and mediastinal widening, which, together with systemic symptoms, simulated lymphoma. An 18-year-old man (A.P., RIE 110264–1100) had ingrowing toe nails removed in 1982 and subsequently noticed numbness of the big toes, extending onto the dorsum of both feet, and a tendency to lift the feet high when walking. On general examination he had mild pectus excavatum, bilateral pes cavus and paronychiae affecting both great toes. The ...