Bing-Neel syndrome

Case contributed by Dr Sarah Robertson


Progressive peripheral neuropathy on a background of Waldenström's macroglobulinaemia.

Patient Data

Age: 75 years
Gender: Male

Smooth enhancement of the cauda equina nerve roots. No nerve root clumping. Normal appearance of the spinal cord.

Diffusely reduced bone marrow signal intensity in keeping with increased hematopoiesis/bone marrow infiltration.

Case Discussion

In the setting of Waldenström macroglobulinemia, the finding of smooth enhancement of the cauda equina is consistent with Bing-Neel syndrome. This is a rare neurologic complication of this disease resulting from direct infiltration of the CNS by lymphoplasmacytic cells. The differential (in a different clinical scenario) would be Guillain-Barré syndrome.

CSF studies showed increased protein and a cell population suspicious for a B-cell lymphoproliferative disorder, confirming the diagnosis.

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Case information

rID: 71453
Published: 9th Oct 2019
Last edited: 9th Oct 2019
Inclusion in quiz mode: Included

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