title: Progressive neurolymphomatosis with cutaneous disease: response in a patient with mycosis fungoides.
abstract: Peripheral neurolymphomatosis is a rare manifestation of advanced lymphoproliferative disorders. It is often associated with B cell lymphomas and rarely with cutaneous T cell lymphomas, such as mycosis fungoides and Sézary syndrome. In this case report, we present a 78-year-old male with a long-standing history of mycosis fungoides. The patient initially presented with chronic peripheral neuropathy in an ulnar nerve distribution. After an unsuccessful ulnar nerve transposition, the ulnar nerve was re-explored and a mass consistent with diffuse lymphomatous infiltration was diagnosed. Magnetic resonance (MR) imaging of the left brachial plexus and later of the sacral plexus demonstrated diffuse thickening and peripheral nodularity in keeping with neurolymphomatosis. The patient's clinical course rapidly deteriorated thereafter and the patient succumbed to his disease. Although uncommon, neurolymphomatosis may be considered in patients with chronic peripheral neuropathy and an underlying history of a lymphoproliferative disorder. US and MR may serve as helpful non-invasive adjuncts in making the diagnosis and identifying sites for biopsy.
authors.affiliation: Department of Medical Imaging, The Ottawa Hospital - General Campus, 501 Smyth Road, Ottawa, ON, Canada K1H 8L6. rhanna@toh.on.ca
authors.forename: Ramez
authors.initials: R
authors.lastname: Hanna
authors.forename: Gina A
authors.initials: GA
authors.lastname: Di Primio
authors.forename: Mark
authors.initials: M
authors.lastname: Schweitzer
authors.forename: Carlos
authors.initials: C
authors.lastname: Torres
authors.forename: Adnan
authors.initials: A
authors.lastname: Sheikh
authors.forename: Santanu
authors.initials: S
authors.lastname: Chakraborty
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009182:Mycosis Fungoides / Q000000981:diagnostic imaging* / Q000473:pathology*; D009423:Nervous System Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D014463:Ultrasonography / Q000379:methods