Fluorothymidine PET/CT in neurolymphomatosis

Area of Science:

• Oncology
• Neurology
• Nuclear Medicine

Background:

• Neurolymphomatosis is a rare extranodal lymphoma affecting the nervous system.
• F-FDG PET/CT can detect increased tracer uptake in affected nerves but lacks specificity.
• Distinguishing lymphoma from inflammatory conditions in the nervous system can be challenging.

Observation:

• A patient with suspected neurolymphomatosis underwent both F-FDG PET/CT and F-fluorothymidine PET/CT.
• Both imaging modalities revealed increased tracer uptake in the right sciatic nerve.
• Mediastinal lymph nodes showed F-FDG avidity but not F-fluorothymidine avidity.

Findings:

• Nerve biopsy confirmed neurolymphomatosis in the right sciatic nerve.
• The differing tracer uptake patterns in nerves and lymph nodes provided diagnostic clues.
• F-fluorothymidine PET/CT demonstrated potential to differentiate malignant from inflammatory processes.

Implications:

• Combined F-FDG and F-fluorothymidine PET/CT may improve the diagnosis of neurolymphomatosis.
• This approach could aid in differentiating neoplastic from inflammatory etiologies in nerve and nodal imaging.
• Further research is warranted to establish the role of F-fluorothymidine PET/CT in neurolymphomatosis.