Open AccessHigh-grade B-cell lymphoma relapse presenting as neurolymphomatosis of the median nerve
Author(s) -
Rebecca Tai,
Julian Maingard,
Mithun Nambiar,
Ki-Dong Lim
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2018-228742
Subject(s) - medicine , vascularity , ultrasound , lymphoma , radiology , malignancy , biopsy , positron emission tomography , fluorodeoxyglucose , nuclear medicine , pathology
Neurolymphomatosis (NL) is the infiltration of lymphocytes into the peripheral nervous system in a haematological malignancy. We describe the imaging features of NL in a patient with relapsed Burkitt-like non-Hodgkin's lymphoma on positron emission tomography (PET) and ultrasound. Imaging features on ultrasound are infrequently described and provide useful information in helping to establish an imaging diagnosis of NL. Features of NL in our patient included intense linear fluorodeoxyglucose-18 ( 18 FDG) uptake on PET along the affected median nerve. B-mode ultrasound demonstrated concentric tubular thickening and loss of fascicular architecture. Perineural and intraneural vascularity was present on colour Doppler ultrasound. It is important to be able to correlate ultrasound findings to features observed on 18 FDG-PET as this aids in diagnosis and in guiding potential surgical biopsy.