Long–Standing evolution of paraneoplastic cerebellar degeneration in a diffuse large B-cell lymphoma.

Highlights • Paraneoplastic cerebellar degeneration (PCD) is characterized by a pancerebellar ataxia with diplopia, nystagmus and dysarthria that might evolve subacutely or over months to years, often preceding manifestations of the primary underlying malignancy. • PCD might occur in association with non- Hodgkin's lymphoma. • The case described here exhibited an abrupt onset mimicking a posterior vascular deficit; the subsequent clinical course had step evolution, at 2 years when a marginal-zone B-cell lymphoma was documented, at 8 years when a diffuse large B-cell lymphoma (DLBCL) was diagnosed in an axillary lynphnode and at 13 years when a DLBCL was discovered in the lung. The ataxia in our patient had insidious and chronic progression over 15 years, antedating the first hematologic diagnosis by 2 years. • Brain magnetic resonance imaging (MRI) was unremarkable in the early phase, but it evolved over 10 months toward a severe cerebellar atrophy. Such progression hints at a prolonged immunological process, with onset long before symptom's appearance. [ABSTRACT FROM AUTHOR]