Diagnostic Yield of FDG-PET/CT, MRI, and CSF Cytology in Non-Biopsiable Neurolymphomatosis as a Heralding Sign of Recurrent Non-Hodgkin's Lymphoma.
Neurolymphomatosis (NL) is a rare condition associated with lymphomas in which various structures of the nervous system are infiltrated by malignant lymphocytes. Rarely, it may be the presenting feature of recurrence of lymphoma otherwise deemed to be in remission. It is crucial, as is the case with all types of nodal or visceral involvement of lymphoma, to identify the disease early and initiate treatment with chemotherapy and/or radiation therapy. Positron emission tomography-computed tomography (PET-CT) has been shown to be a sensitive modality for staging, restaging, biopsy guidance, therapy response assessment, and surveillance for recurrence of lymphoma. Magnetic resonance imaging (MRI) is another useful imaging modality, which, along with PET/CT, compliment cerebrospinal spinal fluid (CSF) cytology and electromyography (EMG) in the diagnosis of NL. Performing nerve biopsies to confirm neurolymphomatosis can be challenging and with associated morbidity. The case presented herein illustrates the practical usefulness of these tests in detecting NL as a heralding feature of lymphoma recurrence, especially in the absence of histopathologic correlation.
Imaging Informatics, University of Pittsburgh Medical Center ; Molecular Imaging Physician, S&L Readings, LLC. ; CEO, Crunchtimr Medical Solutions, LLC.
Faiq
F
Shaikh
Department of Internal Medicine, University of Iowa Hospitals and Clinics.
Aubrey C
AC
Chan
Department of Radiology, Dartmouth Hitchcock Medical Center.
Omer
O
Awan
Department of Neurology, University of Iowa Hospitals and Clinics.
Nivedita
N
Jerath
Department of Neurosurgery, University of Iowa Hospitals and Clinics.
Chandan
C
Reddy
Department of Internal Medicine, University of Missouri Kansas City.
Salman A
SA
Khan
Department of Radiology, University of Iowa Hospitals and Clinics.
Michael M
MM
Graham
csf cytology; diffuse large b-cell lymphoma (dlbcl); fdg; mri; neurolymphomatosis; non-hodgkin's lymphoma; pet-ct