Fig. 1

Simplified mechanism of paraneoplastic immune neurologic injury. This figure summarizes the theorized immune mechanism of paraneoplastic neurologic syndromes. The beast tumor microenvironment contains immune cells such as CD4⁺ T cells, CD8⁺ T cells, NK cells, macrophages, dendritic cells (DC) and others. When tumor cells undergo apoptosis, the DC’s may phagocytose them, travel to lymphoid nodes (or other lymphoid structures) to present antigen to CD4⁺ and CD8⁺ T-cells and even B-cells. Certain activated T cells and autoimmune antibodies may then cross the blood brain barrier where normally immunologically privileged neurons may be targeted by antibody or T cells or both