Abstract
Neurolymphomatosis (NL) is a rare clinical disease where neoplastic cells invade the cranial nerves and peripheral nerve roots, plexus, or other nerves in patients with hematologic malignancy. Most NL cases are caused by B-cell non-Hodgkin's lymphoma (NHL). Diagnosis can be made by imaging with positron emission tomography (PET) and magnetic resonance imaging (MRI). We experienced two cases of NL involving the brachial plexus in patients with NHL. One patient, who had NHL with central nervous system (CNS) involvement, experienced complete remission after 8 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy but relapsed into NL of the brachial plexus 5 months later. The other patient, who suffered from primary central nervous system lymphoma (PCNSL), had been undergoing chemoradiotherapy but progressed to NL of the brachial plexus.
Highlights
Neurolymphomatosis (NL) is the term for nerve infiltration by neurotropic neoplastic cells in non-Hodgkin’s lymphoma (NHL) or acute leukemia [1]
NL can occur as a primary presentation of NHL but is more often seen when lymphoma disseminates into the peripheral nervous system from systemic sites or the central nervous system (CNS) [2]
We report here on two cases of NL that developed in the brachial plexus, diagnosed by magnetic resonance imaging (MRI) and positron emission tomography (PET)-CT
Summary
Neurolymphomatosis (NL) is the term for nerve infiltration by neurotropic neoplastic cells in non-Hodgkin’s lymphoma (NHL) or acute leukemia [1]. The precise incidence is not known, it is estimated to occur in about 0.2% of all NHL patients [1]. NL can occur as a primary presentation of NHL but is more often seen when lymphoma disseminates into the peripheral nervous system from systemic sites or the CNS [2]. The presenting symptoms are diverse, depending on the sites involved. Parallel use of magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET-CT) can be effective, though biopsy of the involved structure is the gold standard method for diagnosis. PET-CT in particular appears to be a highly sensitive tool to diagnose NL [2, 3]. We report here on two cases of NL that developed in the brachial plexus, diagnosed by MRI and PET-CT
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