Neurolymphomatosis as a late relapse of non-Hodgkin's lymphoma detected by 18F-FDG PET/CT: a case report

Rev Esp Med Nucl Imagen Mol. 2014 Jan-Feb;33(1):39-42. doi: 10.1016/j.remn.2013.03.004. Epub 2013 May 15.

Abstract

Neurolymphomatosis is a rare condition defined as an infiltration of nerves, nerve roots or nervous plexuses by haematological malignancy. Its diagnosis may sometimes be difficult with conventional imaging techniques. This paper aims to emphasize the importance of this entity and the role of (18)F-FDG PET/CT in this indication. We present the case of a 53-year-old male who complained of sharp pain in his right hip and right leg paresthesia after 2 years of complete remission from Non-Hodgkin's lymphoma. Physical examination and CT scan were negative and the lumbar MRI showed protrusion of L5-S1 disc. Physiotherapy, nonsteroid antiinflammatory drugs and steroids were inefficient. PET/CT was performed four months after the onset of the symptoms, revealing focal FDG uptake in the right S1 nerve root and linear FDG uptake along the right sacral plexus suggesting relapse. This was confirmed by histology.

Keywords: Diffuse large B-cell lymphoma; FDG; Linfoma difuso de células grandes B; Linfoma no Hodgkin; Neurolinfomatosis; Neurolymphomatosis; Non-Hodgkin's lymphoma; PET/CT; PET/TAC.

Publication types

  • Case Reports

MeSH terms

  • Fluorodeoxyglucose F18*
  • Humans
  • Intervertebral Disc Displacement / complications
  • Intervertebral Disc Displacement / diagnosis
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbosacral Plexus / diagnostic imaging*
  • Lymphoma, Large B-Cell, Diffuse / diagnostic imaging*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neoplasm Invasiveness / diagnostic imaging
  • Pain / etiology
  • Paresthesia / etiology
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals*
  • Recurrence
  • Spinal Nerve Roots / diagnostic imaging*
  • Tomography, X-Ray Computed / methods*

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18