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Neurolymphomatosis; a case report.

Noha Aboueldahab¹, Mohamed Ahmed Shafik², Ayah Megahed³

¹University of Washington, United States of America.

Clinical Imaging

|September 6, 2021

Summary

This case study details a patient diagnosed with diffuse large B-cell lymphoma affecting nerve roots. Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) was crucial for diagnosis and treatment monitoring.

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Area of Science:

Neurology
Oncology
Radiology

Background:

Neurolymphomatosis is a rare condition involving lymphoma infiltration of peripheral nerves.
Differentiating neurolymphomatosis from other neuropathies, like diabetic amyotrophy, can be challenging.

Observation:

A 55-year-old male with diabetes presented with progressive right leg pain and weakness.
Initial imaging showed a sciatic nerve mass; biopsy was inconclusive.
FDG-PET/CT identified the extent of disease and guided a second biopsy.

Findings:

The diagnosis was diffuse large B-cell lymphoma involving lumbosacral nerve roots.
The patient achieved a partial response after chemotherapy.
Complete metabolic response was observed after radiation therapy for residual disease.

Keywords:

Neurolymphomatosis PET/CT

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Implications:

FDG-PET/CT is valuable for diagnosing and staging neurolymphomatosis.
This case highlights the importance of advanced imaging in complex neurological presentations.
Multimodal treatment including chemotherapy and radiation can be effective for neurolymphomatosis.