Oner Ali Ozan, Okuyucu Kursat, Alagoz Engin, Battal Bilal, Arslan Nuri
Department of Nuclear Medicine, Afyon Kocatepe University, Afyon, Turkey.
Department of Nuclear Medicine, Gulhane Military Medical Academy, Ankara, Turkey.
World J Nucl Med. 2016 Sep;15(3):209-11. doi: 10.4103/1450-1147.172304.
Neurolymphomatosis (NL) is a rarely seen neurologic involvement of the systematic lymphoma. Its diagnosis is challenging, and requires biopsy. In cases where biopsy is not appropriate, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) may aid in diagnosis. Here, we present a 54-year old male patient diagnosed with Burkitt lymphoma who underwent FDG-PET/CT in order to evaluate the treatment response after chemotherapy and radiotherapy. On viewing PET/CT images of the patient who complained of pain and weakness in his upper extremities after therapy, linear FDG uptake was observed in bilateral cervical 5 (C5), left cervical 6 (C6), bilateral cervical 7 (C7), and right lumbar 4 (L4) nerve roots. Magnetic resonance imaging (MRI) revealed dilation and thickening of nerve roots consisted with FDG uptake observed on PET/CT images. Since biopsy was not performed, histopathological diagnosis could not be established. However, overlapping of clinical, PET/CT, and MRI findings strongly suggested the presence of NL. As is the case of this patient, in cases with non-Hodgkin lymphoma, a combined evaluation of FDG-PET/CT and MRI modalities aid in the establishment of the diagnosis of NL.
神经淋巴瘤(NL)是系统性淋巴瘤罕见的神经系统受累表现。其诊断具有挑战性,需要进行活检。在不适合活检的情况下,18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(FDG-PET/CT)可能有助于诊断。在此,我们报告一名54岁男性患者,诊断为伯基特淋巴瘤,为评估化疗和放疗后的治疗反应而接受了FDG-PET/CT检查。在查看该患者治疗后出现上肢疼痛和无力症状的PET/CT图像时,在双侧颈5(C5)、左侧颈6(C6)、双侧颈7(C7)和右侧腰4(L4)神经根处观察到线性FDG摄取。磁共振成像(MRI)显示神经根扩张和增粗,与PET/CT图像上观察到的FDG摄取情况相符。由于未进行活检,无法确立组织病理学诊断。然而,临床、PET/CT和MRI检查结果相互印证,强烈提示存在神经淋巴瘤。正如该患者的情况一样,在非霍奇金淋巴瘤病例中,联合应用FDG-PET/CT和MRI有助于确立神经淋巴瘤的诊断。