Primary Neurolymphoma of the Tibial Nerve: A Case Report with Characteristic MRI Findings

Lee, Jung Eun; An, Jun-Mo; Park, Ji Seon; Ryu, Kyung Nam; Moon, Sung Kyung

doi:10.3348/jksr.2016.75.5.399

Cited by 4 publications

(5 citation statements)

References 12 publications

(7 reference statements)

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“…The prognosis of patients with NL is bleak despite treatment, probably relating to current lack of standardized regimens [3]. Our patient was treated with standard chemotherapy with CNS prophylaxis, and the mass demonstrated positive therapeutic response within a few months.…”

Section: Discussionmentioning

confidence: 86%

“…It is most commonly seen in the context of aggressive sub-types of lymphoma, such as diffuse large B cell non-Hodgkin's lymphoma [2]. Its exact incidence is not well documented [3].…”

Section: Discussionmentioning

confidence: 99%

“…primary neurolymphomatosis, has been most commonly reported within the sciatic nerve [5]. Clinical presentation is variable and includes cranial neuropathy, painful and painless mononeuropathy, painful radiculopathy, and polyneuropathy [3].…”

Section: Discussionmentioning

confidence: 99%

“…MRI usually demonstrates diffuse enlargement of the peripheral nerve or mass formation along the course of the involved nerve. Characteristic MRI features such as tumor homogeneity despite large tumor size, and preservation of adjacent structures including interdigitating nerve fascicles, may be useful imaging features in differentiating NL from other soft tissue tumors [3]. NL can be misdiagnosed as a neurogenic tumor on imaging.…”

Section: Discussionmentioning

confidence: 99%

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Painful right elbow mass

Attard

Saifuddin

2018

Skeletal Radiol

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Section: Discussionmentioning

confidence: 86%

“…It is most commonly seen in the context of aggressive sub-types of lymphoma, such as diffuse large B cell non-Hodgkin's lymphoma [2]. Its exact incidence is not well documented [3].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Painful right elbow mass

Attard

Saifuddin

2018

Skeletal Radiol

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“…The median age at presentation was 62 years, compared to 70 years in a large UK epidemiological survey for diffuse large B-cell lymphoma [32]. Primary sciatic localization was by far most frequent (17, or 73.9%), followed by posterior tibial nerve (8.6%) [11, 12], common or deep fibular nerve (8.6%) [13, 17] and the pelvic segment of the femoral nerve (4.3%) [15]. Isolated lumbosacral plexus branch NL infiltration was the first clinical manifestation of lymphoma in 17 of 23 cases, and was reported in the setting of recurrent lymphoma in six cases.…”

Section: Discussionmentioning

confidence: 99%

Neurolymphomatosis of the lumbosacral plexus and its branches: case series and literature review

et al. 2019

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BackgroundNeurolymphomatosis (NL) is a direct process of invasion of peripheral nerves by lymphoma. It occurs in roughly 5% of patients with lymphoma and represents a particularly difficult diagnostic dilemma when it is the presenting focal manifestation of occult lymphoma.Case presentationWe present 3 examples of invasion of the lumbosacral plexus and its branches. These cases demonstrate a protean clinical picture with regards to the time relationship to the clinical course of lymphoma and the neuroanatomical extent of lumbosacral plexus invasion. We demonstrate the complementary role of different imaging modalities. A review of the literature summarizes 23 reports where lumbosacral plexus invasion was the index manifestation, at the time of first diagnosis or recurrence of lymphoma. This series confirms the strong preponderance of B-cell type (92%). There is a marked predilection for involvement of the sciatic nerve (74%), either focally or in a longitudinally extensive fashion, from the ischium to the popliteal fossa. There can also be restricted and discrete involvement of tibial and fibular branches. In recent years, ultrasound and CT have been given a more limited role, as screening tools or as a guide for biopsy. MRI neurography and PET-CT have become leading diagnostic modalities for diagnosis, staging and assessment of treatment response.ConclusionThe diagnosis of NL may be challenging, and it was once only reached at autopsy. Improved diagnostic imaging of focal or even asymptomatic disease offers new hope for earlier diagnosis and successful targeted therapy.

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