Increasing importance of 18F-FDG PET in the diagnosis of neurolymphomatosis

Salm, Liesbeth P.; Hiel, Bernies van der; Stokkel, Marcel P. M.

doi:10.1097/mnm.0b013e3283561881

Cited by 53 publications

(32 citation statements)

References 44 publications

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“…Interestingly, FDG-PET appears to be a highly sensitive diagnostic method for identifying NL, with a positivity rate as high as 87.5-91% (5, 6). Intense FDG uptake in the involved nerve, as observed in this case, is a typical sign of NL according to a previous report (6). Because the use of FDG-PET is recommended for staging studies and response assessments (7), more cases of NL are likely to be identified.…”

Section: Discussionmentioning

confidence: 71%

Neurolymphomatosis in a Patient with Extranodal NK/T-cell Lymphoma, Nasal-type: A Case Report and Literature Review

et al. 2014

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A 47-year-old man presented with a fever and lower extremity paresthesia. A physical examination revealed sensory deficits in the left hand, distal arm and right sole. A bone marrow aspiration demonstrated infiltration of extranodal NK/T-cell lymphoma, nasal type, and 18 F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) disclosed extensive involvement of the peripheral nerves. These findings were consistent with a diagnosis of neurolymphomatosis (NL). The lymphoma progressed soon after the patient underwent cord blood transplantation, and he died on day 33 after transplantation. NL is a rare manifestation of lymphoma characterized by infiltration of the peripheral nerves, leading to neuropathy. It is an increasingly recognized entity and can be the first indication of lymphoma.

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Section: Discussionmentioning

confidence: 71%

Neurolymphomatosis in a Patient with Extranodal NK/T-cell Lymphoma, Nasal-type: A Case Report and Literature Review

et al. 2014

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“…Unlike a retrospective review of neurolymphomatosis with neurologic manifestations of LMD, in which 91% of patients showed abnormal 18 F-FDG avidity in the central or peripheral nervous system, our study demonstrates an overall lower sensitivity of 29% (LMD was detected in six of 21 cases). [17] The lower sensitivity in our study could be attributed to our focusing exclusively on spinal LMD and the fact that the patients we included were undergoing treatment at the time of their initial assessment for LMD. Additionally, our study only included patients with leptomeningeal disease confirmed by cytology.…”

Section: Discussionmentioning

confidence: 77%

Association between 18F-FDG PET/CT and MRI appearance of spinal leptomeningeal disease before and after treatment at a tertiary referral center

Papasozomenos

Guha-Thakurta

Mayer³

et al. 2015

JST

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Objective: Leptomeningeal disease (LMD), the presence of metastasis in the subarachnoid space, has devastating implications if left untreated. The gold standard for LMD diagnosis is cytologic analysis of cerebrospinal fluid (CSF); MRI is also used to evaluate suspected LMD. The purpose of this study was to compare the appearance of LMD in the spinal canal on 18 F-FDG PET/CT imaging with the appearance of LMD on MRI and with CSF cytology. Methods: In twenty-one patients with cytologically-proven spinal LMD, findings on 18 F-FDG PET/CT, MRI, and CSF cytology at diagnosis of LMD and after the initiation of treatment for LMD were retrospectively reviewed. Results: At diagnosis of LMD, abnormal 18 F-FDG avidity was demonstrated in the spinal canal in six patients, and the anatomic distribution of 18 F-FDG activity corresponded to the sites of LMD on MRI. All six of these patients were then treated with intrathecal chemotherapy. Follow-up 18 F-FDG PET/CT and MRI were obtained in four of the six cases. In all four cases, normalization of 18 F-FDG activity in the spinal canal and reduction of enhancement on MRI corresponded to the cytologic response to treatment, as determined by CSF analysis. Conclusion: 18 F-FDG avidity in the spinal canal greater than the normal contents of the canal can suggest spinal LMD. This abnormal avidity may be detected before the diagnosis of LMD has been established with MRI or CSF cytology. The spinal canal should be routinely evaluated on 18 F-FDG PET/CT in patients with suspected LMD so that appropriate treatment is initiated.

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“…FDG-PET is a useful adjunct to the diagnosis and is most sensitive and specific tool currently available for diagnosis of NL [4]- [7]. It may be positive even when all other modalities fail to yield the diagnosis as was in our case [5]. Tissue diagnosis remains the gold standard and there is tumor cell infiltration of endoneurium and perineurium.…”

Section: Discussionmentioning

confidence: 95%

Neurolymphomatosis: A Rare Cause of Multiple Mononeuropathy

Petluri¹,

Goyal²,

Singla³

et al. 2014

WJNS

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Neurolymphomatosis, defined as invasion of cranial nerves and peripheral nerve roots, plexus or nerves by Non Hodgkin's Lymphoma is a very rare clinical entity. We describe a case of 69 years old gentleman, who presented to us with asymmetric, painful sensorimotor polyneuropathy. He was admitted with 2 months history of dry cough, constitutional symptoms, paraesthesias on right side of face along with painful asymmetrical quadriparesis. Nerve conduction studies were suggestive of asymmetrical sensorimotor axonal and demyelinating neuropathy. Cerebrospinal fluid analysis revealed mild pleocytosis with raised protein. FDG-PET showed intense uptake in both adrenals, abdominal lymph nodes, sacral nerve roots and brachial plexus. Fine needle aspiration cytology of adrenal mass revealed evidence of diffuse large B cell Non Hodgkin's Lymphoma. As patient succumbed to illness, an autopsy was done, which revealed diffuse large B cell lymphoma involving adrenals, brachial and lumbosacral plexuses. Our report provides important insights into a rare cause of painful demyelinating multiple mononeuropathy and emphasises on increasing role and diagnostic utility of PET imaging in evaluation of patients presenting with multiple mononeuropathy, especially with regards to paraneoplastic or neoplastic causes such as lymphoma.

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Increasing importance of 18F-FDG PET in the diagnosis of neurolymphomatosis

Cited by 53 publications

References 44 publications

Neurolymphomatosis in a Patient with Extranodal NK/T-cell Lymphoma, Nasal-type: A Case Report and Literature Review

Neurolymphomatosis in a Patient with Extranodal NK/T-cell Lymphoma, Nasal-type: A Case Report and Literature Review

Association between 18F-FDG PET/CT and MRI appearance of spinal leptomeningeal disease before and after treatment at a tertiary referral center

Neurolymphomatosis: A Rare Cause of Multiple Mononeuropathy

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