title: MRI and PET-CT in the diagnosis and follow-up of a lymphoma case with multifocal peripheral nerve involvement.
abstract: Lymphoma of the peripheral nerve, particularly of the T-cell variety, is an extremely rare subtype of extra nodal lymphoma that has a variable response to current therapeutic regimens. Here, we present a patient with natural killer (NK)/T-cell lymphoma in remission who presented with a two-month history of right forearm swelling and paresthesia in the ulnar nerve distribution. Magnetic resonance imaging (MRI) showed an ulnar nerve mass identified as a nerve sheath tumor. Frozen section and postresection biopsies showed an Epstein-Barr virus-positive NK/T-cell lymphoma, nasal type. Consequently, the patient received chemotherapy following resection. Four months later, the patient developed a proximal leg mass, which was diagnosed as tibial nerve lymphoma. The patient was then treated with chemotherapy and follow-up was done by positron emission tomography-computed tomography (PET-CT). In conclusion, lymphoma should be considered in the differential diagnosis of a peripheral nerve mass. MRI is a useful imaging tool together with PET-CT, which plays a beneficial role in the follow-up of these patients on therapy as well as diagnosis of new lesions.
authors.affiliation: Department of Diagnostic Imaging, National University Hospital, Singapore, Singapore. sachinagrawall@yahoo.co.in
authors.forename: Sachin
authors.initials: S
authors.lastname: Agrawal
authors.forename: Ming Tye
authors.initials: MT
authors.lastname: Gi
authors.forename: Siok Bian
authors.initials: SB
authors.lastname: Ng
authors.forename: Mark Edward
authors.initials: ME
authors.lastname: Puhaindran
authors.forename: Poonam
authors.initials: P
authors.lastname: Singhania
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054391:Lymphoma, Extranodal NK-T-Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D010524:Peripheral Nervous System Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D049268:Positron-Emission Tomography / Q000379:methods*; D013979:Tibial Nerve / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014459:Ulnar Nerve / Q000000981:diagnostic imaging / Q000473:pathology