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Diffuse large B-cell lymphoma relapse presenting as extensive neurolymphomatosis.
Pankaj Nepal1, Prem P Batchala2, Patrice K Rehm2
1Department of Radiology and Medical Imaging, St. Vincent's Medical Center, Bridgeport, CT, USA.
The Neuroradiology Journal
|May 14, 2020
Summary
Secondary neurolymphomatosis (NL), a rare lymphoma complication, presents with difficult-to-diagnose neuropathic symptoms. Advanced imaging like MRI and FDG PET/CT aids diagnosis when nerve biopsy is not feasible.
Area of Science:
- Neurology
- Oncology
- Radiology
Background:
- Diffuse large B-cell non-Hodgkin lymphoma (DLBCL-NHL) can rarely manifest as neurolymphomatosis (NL), affecting the peripheral nervous system.
- Clinical diagnosis of NL is challenging due to nonspecific neuropathic symptoms.
Observation:
- A 56-year-old woman in remission for DLBCL-NHL presented with weight loss and multifocal neurological deficits.
- Neuroimaging revealed extensive cranial and peripheral nerve thickening with abnormal metabolism.
Findings:
- Magnetic resonance imaging (MRI) and whole-body FDG PET/CT confirmed secondary neurolymphomatosis (NL).
- Treatment with chemotherapy led to a complete response, confirmed by FDG PET/CT, followed by autologous stem cell transplantation.
Implications:
- MRI and FDG PET/CT are valuable diagnostic tools for NL, serving as alternatives to nerve biopsy.
- Understanding imaging findings is crucial for diagnosing and managing this rare lymphoma complication.
