Recoverin as a paraneoplastic antigen in a case of diffuse large B-cell lymphoma presenting with Gulliain Barre syndrome - A rare association

ABSTRACT Paraneoplastic syndromes (PNS) are rare manifestations of non-Hodgkin lymphoma (NHL) and can make the treatment of these patients challenging. We report a case on the association of Landry–Guillain–Barre Syndrome (LGBS) and recoverin in a 62-year-old male, without any visual impairment, who presented with a history of pyrexia of unknown origin, ascending paralysis and bowel and bladder incontinence. To the best of our knowledge, this is the first case report, showing the presence of recoverin in a case of NHL. Based on the presence of recoverin antibody and LGBS along with mediastinal lymphadenopathy, a diagnosis of lung carcinoma was strongly suspected in this case. Although the histopathological examination was suggestive of malignant round cell tumour, based upon the immunohistochemistry findings, the diagnosis of diffuse large B-cell lymphoma-non-germinal centre B-cell type (DLBCL-Non-GCB) was rendered. With immediate immunochemotherapeutic directives and with a short course of intravenous immunoglobulin, the patient showed prompt neurological recovery. This report highlights the rare association between recoverin antibody, LGBS and DLBCL-Non-GCB subtype, in which full remission was achievable with early and prompt immunotherapeutic regimen.