Interesting association of neurofibroma with diffuse cystic lung disease (NF-DLD)

Description

A man aged 46 years presented with gradually progressive weakness of bilateral lower limbs and reduced sensation below the level of nipple for the past 2 months. There was no history of upper limb weakness and his bowel and bladder movements were normal. On enquiry, he also has a 2-year history of dry cough, wheeze and exertional dyspnoea. He is a non-smoker with no other significant medical history. On examination, power of bilateral lower limbs was 0/5, and knee and ankle reflexes were brisk with extensor plantar response. The patient had decreased sensation below the level of D5 vertebra. He had bilateral occasional rhonchi on chest auscultation. MRI of the spinal cord revealed benign intraspinal extradural dumb-bell-shaped lesion, measuring 3.8x2.0x3.0 cm, isointense on T2WI, hyperintense on T1WI, STIR noted at the D6–7 level causing significant spinal cord compression suggestive of neurogenic tumour (Neurofibroma/Schwannoma) (figures 1 and

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