Sciatic and median nerve neurolymphomatosis as initial presentation of B-cell Lymphoma

D Barahona; I Adlerstein; J Donoso; F Mercado

doi:10.1016/j.rx.2020.10.008

Sciatic and median nerve neurolymphomatosis as initial presentation of B-cell Lymphoma

Radiologia (Engl Ed). 2020 Dec 24:S0033-8338(20)30171-5. doi: 10.1016/j.rx.2020.10.008. Online ahead of print.

[Article in English, Spanish]

Authors

D Barahona¹, I Adlerstein², J Donoso³, F Mercado²

Affiliations

¹ Departamento de Imagenología, Facultad de Medicina, Clínica Alemana-Universidad del Desarrollo, Vitacura, Santiago, Chile. Electronic address: danibarahona@gmail.com.
² Departamento de Imagenología, Facultad de Medicina, Clínica Alemana-Universidad del Desarrollo, Vitacura, Santiago, Chile.
³ Departamento de Hematología, Facultad de Medicina, Clínica Alemana-Universidad del Desarrollo, Vitacura, Santiago, Chile.

PMID: 33358595
DOI: 10.1016/j.rx.2020.10.008

Abstract

Neurolymphomatosis (NL) is the infiltration of cranial nerves or nerves and roots from the peripheral nervous system by lymphoma, usually by B-cell non-Hodgkin's lymphoma. It is uncommon as initial presentation of the disease and can lead to extremely heterogeneous clinical manifestations. We report the case of a 72-year old male who presented with numbness of the right hand, progressive weakness in both lower limbs and weight loss. 18F-FDG PET/CT showed bilateral hypermetabolic adrenal masses, gastric ulcer, small hypermetabolic adenopathies, multiple focal bone marrow uptake and intense uptake in both sciatic nerves and right median nerve. A node and gastric biopsy confirmed diffuse large-B-cell lymphoma, activated B cell type, with posterior resolution of peripheral nerves uptake after beginning chemotherapy.

Keywords: Diffuse large-B-cell lymphoma; Linfoma difuso de linfocitos B grandes; Neurolinfomatosis; Neurolymphomatosis; Neuropathy; Neuropatía; PET.