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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Neurolymphomatosis as a late relapse of non-Hodgkin's lymphoma detected by 1...
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Vol. 33. Issue 1.
Pages 39-42 (January - February 2014)
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Vol. 33. Issue 1.
Pages 39-42 (January - February 2014)
Clinical note
Neurolymphomatosis as a late relapse of non-Hodgkin's lymphoma detected by 18F-FDG PET/CT: A case report
Neurolinfomatosis como recaída de un linfoma no Hodgkin detectada con 18F-FDG PET/TAC: a propósito de un caso
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K. Kajárya,
Corresponding author
, Z. Molnárb, I. Mikóc, P. Barsid, Z. Lengyela, S. Szakáll Jra
a Pozitron PET/CT Center, Budapest, Hungary
b National Institute of Oncology, Budapest, Hungary
c National Institute of Rheumatology and Physiotherapy, Budapest, Hungary
d MR Research Center, Semmelweis University, Budapest, Hungary
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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 18F-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:
Neurolymphomatosis
Non-Hodgkin's lymphoma
Diffuse large B-cell lymphoma
FDG
PET/CT
Resumen

La neurolinfomatosis es una entidad rara definida por la infiltración de los nervios, raíces o plexos nerviosos por un proceso hematológico maligno, siendo en ocasiones difícil de diagnosticar mediante técnicas de imagen convencionales. La finalidad del caso es llamar la atención sobre su importancia y el papel de la 18F-FDG PET/TAC. Presentamos el caso de un varón de 53 años con dolor en la región de la cadera derecha y parestesias en la pierna derecha tras 2 años de remisión completa de un linfoma no Hodgkin. El examen físico y la TAC fueron negativos, mostrando la RM lumbar una protrusión discal en L5-S1. El tratamiento con fisioterapia y con antiinflamatorios no esteroideos y esteroideos fue ineficaz. La PET/TAC realizada a los 4 meses reveló una captación focal de FDG en la raíz del nervio S1 derecho y una captación lineal a lo largo del plexo sacro derecho sugestivo de recaída del linfoma, lo que fue confirmado por la histología.

Palabras clave:
Neurolinfomatosis
Linfoma no Hodgkin
Linfoma difuso de células grandes B
FDG
PET/TAC

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