case_images: PMC10869174_01
case_images: T2-weighted coronal magnetic resonance imaging (MRI) of the cervical area after diagnosis of Waldenstrom macroglobulinemia (MW)-associated peripheral neuropathy (PN). Yellow arrows indicate the brachial plexus. (A) Before treatment for PN and (B) 15 months after treatment with tirabrutinib.
case_images: cureus-0016-00000052400-i01.jpg
case_images: PMC10869174_01_cureus-0016-00000052400-i01.jpg
case_images: FIG1
case_images: In Figure 1, magnetic resonance imaging (MRI) revealed diffuse bilateral symmetric swelling of the nerve root to the brachial plexus at the C4-Th1 level (Figure 1A) with normal brain, cervical, and thoracic spines. Re-evaluation before the resumption of tirabrutinib treatment (15 months after the initial treatment with tirabrutinib) confirmed a reduction in the pretreatment swelling of the nerve root and brachial plexus (Figure 1B).
case_images: Cerebrospinal fluid (CSF) image at the diagnosis of Bing-Neel syndrome (BNS) (Giemsa staining, x400)
case_images: cureus-0016-00000052400-i02.jpg
case_images: PMC10869174_01_cureus-0016-00000052400-i02.jpg
case_images: FIG2
case_images: A repeat CSF test three weeks after the first test revealed the presence of the IgM-kappa type M protein and an increase in the number of abnormal lymphoplasmacytic cells (189/microL) (Figure 2).
case_images: Clinical course of the patient after the diagnosis of Bing-Neel syndrome (BNS). CSF: cerebrospinal fluid; Ig: immunoglobulin; IVIG: intravenous immunoglobulin; PSL: prednisolone; R: rituximab; R-MPV: rituximab-methotrexate-procarbazine-vincristine; WBC: white blood cell
case_images: cureus-0016-00000052400-i03.jpg
case_images: PMC10869174_01_cureus-0016-00000052400-i03.jpg
case_images: FIG3
case_images: The clinical course of the patient is shown in Figure 3.