A 58 y.o. man was admitted to our hospital because of severe progressive untreatable radicular pain, limb weakness, and cranial nerve palsies. The patient was well until 2 years before, when he developed progressive perineal sensory loss with impotence. Two months later, he complained of pain in the right foot only partially responding to NSAIDs. A lumbosacral MRI showed a spinal stenosis and multiple lumbar discopathy. During the following year he developed right foot and left arm burning paresthesia only responsive to oral opiates, left facial nerve palsy, right foot drop, arm weakness partially responding to oral steroids, and cyclophosphamide. CSF and electrophysiological studies were consistent with an inflammatory multiple radiculoneuropathy while blood tests, bone scintigraphy, and abdominal echography were normal. Four months before admission, he developed right wrist drop, painful dysesthesia in the left hemithorax, and diplopia. On admission, neurologic examination revealed left oculomotor and facial nerve palsies, distal>proximal weakness in the extensor muscles of the right arm, right foot drop, superficial and deep sensory loss on the right leg, and ubiquitary absent deep tendon reflexes. Four additional spinal taps revealed markedly increased proteins with slightly increased cells (always below 10/mm3) but no tumor cell. Nerve conduction studies were consistent with multiple radiculoneuropathy, while sural nerve biopsy showed an axonal neuropathy. Bone marrow biopsy, chest and abdominal CT, and endoscopy of the gastrointestinal tract were negative for neoplastic lesions. A brain and cervical MRI revealed multiple gadolinium enhancing hyperlucencies in the thalamus, caudate nucleus, and spinal cord. The patient was treated with intravenous steroids and IVIg with no response and with opiates for severe pain. One month later, the patient developed deep vein thrombosis treated with anticoagulants followed four days later by a fatal massive intracranial hemorrhage. Autoptic studies revealed a widespread non‐Hodgkin's type B lymphoblastic centrocitic lymphoma involving the stomach, liver, lung, thyroid, spleen, cauda equina, brain, and the spinal cord.This report draws attention to the unusual presentation of a lymphoproliferative disease that escaped an extensive diagnostic evaluation during life.