Impact of 18F-FDG PET/CT in Predicting Recurrence in Neurolymphomatosis

Megumi Uemichi,Kota Yokoyama,Kosei Matsue,Youichi Machida,Ukihide Tateishi,Toshiki Terao,Junichi Tsuchiya

doi:10.3390/hemato2030038

Megumi Uemichi, Kota Yokoyama + Show 5 more

Open Access

https://doi.org/10.3390/hemato2030038

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Abstract

To clarify the prognostic value of 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) in Neurolymphomatosis (NL), we retrospectively reviewed medical records of all NL patients who had undergone 18F-FDG PET/CT from 2007 to 2020 at Kameda Medical Center and Tokyo Medical and Dental University Hospital. The clinical data of patients were compared with 18F-FDG PET/CT findings of number of nerve lesions and presence of non-nerve extranodal lesions (ENL). Subsequently, we calculated recurrence-free survival (RFS) and overall survival (OS) using the Kaplan–Meier method. A total of 28 patients (mean age 70.1 years, range 44–87 years; 15 women) were included in the study and 7 patients (25.0%) relapsed NL. The number of nerve lesions detected by 18F-FDG PET/CT ranged from 1 to 5, with an average of 2.02. ENL was observed in 18 cases (64.3%). The comparison between the findings revealed that the more the lesions detected by 18F-FDG PET/CT, the higher the probability of recurrence (χ2 = 13.651, p = 0.0085) and there was significantly shorter RFS for the patients with 3 or more nerve lesions (p = 0.0059), whereas the presence of ENL was not significantly associated with any clinical findings. The present study revealed that the more nerve lesions detected by 18F-FDG PET/CT, the poorer the recurrence rate and RFS.

Highlights

Neurolymphomatosis (NL) is a rare condition that occurs in patients with malignant lymphoma (ML) and is characterized by the direct invasion of the peripheral nervous system by neoplasm cells
We retrospectively reviewed the medical records and imaging findings of all NL patients who had undergone 18 F-FDG PET/CT between February 2007 and December 2020 in Kameda Medical Center (KMC) and Tokyo Medical and Dental University Hospital (TMDUH)
Of the 28 patients included in the study, 24 were from KMC and the remaining four were from TMDUH

Summary

Introduction

Neurolymphomatosis (NL) is a rare condition that occurs in patients with malignant lymphoma (ML) and is characterized by the direct invasion of the peripheral nervous system by neoplasm cells. It is most observed in patients with non-Hodgkin’s B-cell lymphoma (NHL), especially in cases of diffuse large B-cell lymphoma (DLBCL) [1,2,3]. The peripheral nerves are the main target of NL (60%), followed by the spinal nerves (48%), cranial nerves (46%), and plexus (40%) [1]. Common presentations include painful peripheral neuropathy or radiculopathy, cranial neuropathy, painless polyneuropathy, peripheral mononeuropathy, or mononeuropathy multiplex [1,4].

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