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Neurolymphomatosis: A Comprehensive Review of Clinical and Imaging Features
Mona Gad1,2, Greg Pommier3, Rebecca Choi1
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287.
Neurolymphomatosis (NL) involves malignant lymphocytes infiltrating the peripheral nervous system, often complicating lymphoma. Advanced imaging like MRI and FDG PET/CT aids in early detection and management of this rare condition.
Area of Science:
- Neuroscience
- Oncology
- Radiology
Background:
- Neurolymphomatosis (NL) is a rare condition involving malignant lymphocyte infiltration of the peripheral nervous system.
- It is frequently associated with hematologic malignancies, particularly non-Hodgkin lymphoma, as a form of extranodal disease.
Purpose of the Study:
- To review the clinical presentation, diagnostic challenges, and imaging features of NL.
- To emphasize the role of MRI and 18F-FDG PET/CT in detecting, diagnosing, and assessing the extent of NL.
Main Methods:
- Review of clinical presentations and diagnostic approaches for NL.
- Highlighting the utility of Magnetic Resonance (MR) neurography and 18F-FDG PET/CT imaging.
Main Results:
- NL presents with diverse symptoms, often leading to misdiagnosis; red flags include severe pain and asymmetric neuropathy.
- Commonly affected sites include the brachial plexus, lumbosacral plexus, sciatic, and trigeminal nerves.
- MR neurography and 18F-FDG PET/CT offer high diagnostic yield for early detection and disease extent assessment.
Conclusions:
- While nerve biopsy is the gold standard, it carries risks; advanced imaging is crucial for early diagnosis and management.
- MRI and 18F-FDG PET/CT are essential tools for evaluating NL extent, guiding biopsies, and monitoring treatment.
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