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Secondary neurolymphomatosis detected by whole-body diffusion-weighted magnetic resonance imaging: a case report.
- Source :
-
Journal of clinical and experimental hematopathology : JCEH [J Clin Exp Hematop] 2013; Vol. 53 (3), pp. 221-6. - Publication Year :
- 2013
-
Abstract
- Neurolymphomatosis (NL) is a rare clinical entity defined as peripheral nervous system infiltration by lymphoma. The diagnosis is difficult and often elusive. Whole-body diffusion-weighted magnetic resonance imaging (DW MRI) was developed to enhance the detection of vaguely delineated tumors. Here, we describe the case of a 71-year-old male with secondary NL of diffuse large B-cell lymphoma (DLBCL) that was successfully detected by whole-body DW MRI. The patient was diagnosed with DLBCL extending from the ethmoidal sinus to the nasal cavity, orbital cavity, and anterior cranial fossa. Although he was administered R-THP-COP chemotherapy and the tumor remarkably decreased in size, he developed painful paresthesia and weakness in the left upper and bilateral lower extremities during treatment. Because lymphoma cells were detected in his spinal fluid, high-dose methotrexate (MTX) and weekly intrathecal MTX and cytarabine injections were administered. Test results for lymphoma cells in the spinal fluid became negative ; however, the neurological disorders progressed. Whole-body DW MRI was performed as whole-body screening and could localize NL at the left cervical and bilateral lumbar nerve roots. Both cervical spine plain MRI and enhanced computed tomography performed around the same time could not detect the cervical lesion. Our case report suggests that whole-body DW MRI is a useful diagnostic imaging procedure, especially as whole-body screening in facilities where PET/CT is not available.
- Subjects :
- Aged
Antibodies, Monoclonal, Murine-Derived administration & dosage
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Cyclophosphamide therapeutic use
Doxorubicin analogs & derivatives
Doxorubicin therapeutic use
Ethmoid Sinus pathology
Fatal Outcome
Humans
Lymphoma, Large B-Cell, Diffuse drug therapy
Male
Neoplasms, Second Primary drug therapy
Paranasal Sinus Neoplasms diagnosis
Peripheral Nervous System Neoplasms drug therapy
Prednisolone therapeutic use
Psoas Muscles pathology
Rituximab
Vincristine therapeutic use
Diffusion Magnetic Resonance Imaging
Lymphoma, Large B-Cell, Diffuse diagnosis
Neoplasms, Second Primary diagnosis
Peripheral Nervous System Neoplasms diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1880-9952
- Volume :
- 53
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of clinical and experimental hematopathology : JCEH
- Publication Type :
- Academic Journal
- Accession number :
- 24369224
- Full Text :
- https://doi.org/10.3960/jslrt.53.221