Circumdural extension of perineural spread leading to bilateral disease in neurolymphomatosis.

We describe the pathomechanism of spread in our cases of bilateral upper or bilateral lower limb disease, where NL spreads along a dominant nerve toward the spinal canal and moves circumdurally to affect the corresponding contralateral nerve. We believe this information is useful to further understand the spread of NL, as well as offering important diagnostic and prognostic information for patients.