AI Article Synopsis
- Neurolymphomatosis, primarily associated with non-Hodgkin's lymphoma, involves cancerous invasion of nerves and must be differentiated from other causes of neuropathy.
- Various clinical presentations can occur in the brachial plexus, ranging from localized nerve issues to more widespread problems, either indicating the presence of lymphoma or arising during disease relapse.
- Key imaging features like asymmetry, pain, and specific neuroimaging patterns, along with advanced imaging techniques like MRI and PET-CT, are crucial for accurate diagnosis and understanding the neurological complications associated with lymphoma.
Article Abstract
Background: Neurolymphomatosis is a process of neoplastic endoneurial invasion, most strongly associated with non-Hodgkin's lymphoma. It must be distinguished from paraneoplastic, metabolic, nutritional and treatment-related causes of neuropathy that are common in this patient population.
Methods: This brief case series illustrates the protean manifestations of neurolymphomatosis of the brachial plexus, ranging from focal distal mononeuropathy to multifocal brachial plexopathy, either as the index manifestation of lymphoma or as a complication of relapsing disease.
Results: Prominent asymmetry, pain and nodular involvement on neuroimaging may help distinguish neurolymphomatosis from paraneoplastic immune demyelinating radiculoneuropathy. MR neurography criteria for the diagnosis of neurolymphomatosis include hyperintensity on T2 and STIR sequences, focal and diffuse nerve enlargement with fascicular disorganization and gadolinium enhancement. No specific anatomical distribution within the brachial plexus has, however, been found to be characteristic. Fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging is the imaging modality with the highest sensitivity for detection of nodal or extranodal spread in lymphoma.
Conclusions: Brachial plexus neuropathy in neurolymphomatosis is highly protean in its distribution, semiology and relation to lymphoma staging. Dedicated MRI and PET-CT imaging are leading diagnostic modalities.
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| http://dx.doi.org/10.1017/cjn.2017.282 | DOI Listing |
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