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Vol. 64. Issue 3.
Pages 266-269 (May - June 2022)
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Vol. 64. Issue 3.
Pages 266-269 (May - June 2022)
Brief report
Sciatic and median nerve neurolymphomatosis as initial presentation of B-cell lymphoma
Neurolinfomatosis de los nervios ciático y mediano como presentación inicial del linfoma de linfocitos B
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D. Barahonaa,
Corresponding author
danibarahona@gmail.com

Corresponding author.
, I. Adlersteina, J. Donosob, F. Mercadoa
a Departamento de Imagenología, Facultad de Medicina, Clínica Alemana-Universidad del Desarrollo, Vitacura, Santiago, Chile
b Departamento de Hematología, Facultad de Medicina, Clínica Alemana-Universidad del Desarrollo, Vitacura, Santiago, Chile
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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:
Neurolymphomatosis
PET
Neuropathy
Diffuse large-B-cell lymphoma
Resumen

La neurolinfomatosis es la infiltración de los nervios craneales o de los nervios y raíces del sistema nervioso periférico por un linfoma, generalmente un linfoma no Hodgkin de linfocitos B. Es poco frecuente como presentación inicial de la enfermedad y puede dar lugar a manifestaciones clínicas extremadamente heterogéneas. Informamos del caso de un hombre de 72 años que presentaba entumecimiento de la mano derecha, debilidad progresiva en ambas extremidades inferiores y pérdida de peso. La PET/TC con 18F-FDG mostró masas suprarrenales hipermetabólicas bilaterales, úlcera gástrica, pequeñas adenopatías hipermetabólicas, captación de médula ósea de focalización múltiple y captación intensa tanto en los nervios ciáticos como en el nervio mediano derecho. La biopsia gástrica y de los ganglios confirmó un linfoma difuso de linfocitos B grandes, del tipo de linfocitos B activados, con una resolución posterior de la captación de los nervios periféricos después de iniciar la quimioterapia.

Palabras clave:
Neurolinfomatosis
PET
Neuropatía
Linfoma difuso de linfocitos B grandes

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