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Current Medical Imaging

Author(s): Nan Zhuang, Lu Xie, Dongsheng Liu and HaiQin Xie*

DOI: 10.2174/0115734056281665231221051933

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The Value of Nerve Ultrasound to Diagnose and Follow Up the Multifocal Neurolyphomatosis in the Upper Limb---- Case Report and Literature Review

Article ID: e15734056281665 Pages: 5

  • * (Excluding Mailing and Handling)

Abstract

Introduction: Neurolymphomatosis (NL) is a rare disease. Ultrasound (US) plays a crucial role in diagnosing and following up the NL.

Case Presentation: A 59-year-old man was hospitalized with acute pain in the left upper extremity. Ultrasound revealed segmental swelling of multiple nerves around his left elbow with abundant blood flow signals. Contrast-Enhanced Ultrasound (CEUS) showed a rapid, complete and homogenous enhancement in the nerve lesions in the early arterial phase. The NL was confirmed by imaging and flow cytometry, and he accepted chemotherapy. The posttherapeutic ultrasound showed that the nerves in the left upper limb were basically normal. Unfortunately, the patient died of cerebral metastasis in 5 months.

Conclusion: The nerve US and CEUS can show specific manifestations and provide more diagnostic information about NL.

[1]
Tomita M, Koike H, Kawagashira Y, et al. Clinicopathological features of neuropathy associated with lymphoma. Brain 2013; 136(8): 2563-78.
[http://dx.doi.org/10.1093/brain/awt193] [PMID: 23884813]
[2]
Gwathmey KG. Plexus and peripheral nerve metastasis. Handb Clin Neurol 2018; 149: 257-79.
[http://dx.doi.org/10.1016/B978-0-12-811161-1.00017-7] [PMID: 29307357]
[3]
Sasaki R, Ohta Y, Yamada Y, et al. Neurolymphomatosis in the cauda equina diagnosed by an open biopsy. Intern Med 2018; 57(23): 3463-5.
[http://dx.doi.org/10.2169/internalmedicine.1049-18] [PMID: 30101916]
[4]
Baehring JM, Batchelor TT. Diagnosis and management of neurolymphomatosis. Cancer J 2012; 18(5): 463-8.
[http://dx.doi.org/10.1097/PPO.0b013e31826c5ad5] [PMID: 23006953]
[5]
Haydaroglu Sahin H, Mete A, Pehlivan M. Neurolymphomatosis in non-Hodgkin lymphoma with cranial multineuritis. Medicine 2018; 97(15): e0303.
[http://dx.doi.org/10.1097/MD.0000000000010303] [PMID: 29642156]
[6]
Bourque PR, Warman Chardon J, Bryanton M, Toupin M, Burns BF, Torres C. Neurolymphomatosis of the brachial plexus and its branches: Case series and literature review. Can J Neurol Sci 2018; 45(2): 137-43.
[http://dx.doi.org/10.1017/cjn.2017.282] [PMID: 29307326]
[7]
Mori Y, Yamamoto K, Ohno A, Fukunaga M, Nishikawa A. Primary central nervous system lymphoma with peripheral nerve involvement: Case report. Cureus 2019; 11(9): e5675.
[http://dx.doi.org/10.7759/cureus.5675] [PMID: 31723484]
[8]
Keddie S, Nagendran A, Cox T, et al. Peripheral nerve neurolymphomatosis: Clinical features, treatment, and outcomes. Muscle Nerve 2020; 62(5): 617-25.
[http://dx.doi.org/10.1002/mus.27045] [PMID: 32786031]
[9]
Trevisan A, Ribeiro F, Itikawa E, et al. 18F-FDG pet/ct/mri fusion images showing cranial and peripheral nerve involvement in neurolymphomatosis. Indian J Nucl Med 2017; 32(1): 77-8.
[http://dx.doi.org/10.4103/0972-3919.198502] [PMID: 28242998]
[10]
Pedro MT, Antoniadis G, Scheuerle A, Pham M, Wirtz CR, Koenig RW. Intraoperative high-resolution ultrasound and contrast-enhanced ultrasound of peripheral nerve tumors and tumorlike lesions. Neurosurg Focus 2015; 39(3): E5.
[http://dx.doi.org/10.3171/2015.6.FOCUS15218] [PMID: 26323823]
[11]
Vijayan J, Chan YC, Therimadasamy A, Wilder-Smith EP. Role of combined B-mode and doppler sonography in evaluating neurolymphomatosis. Neurology 2015; 85(9): 752-5.
[http://dx.doi.org/10.1212/WNL.0000000000001880] [PMID: 26231262]
[12]
Qureshi AI, Saleem MA, Ahrar A, Raja F. Imaging of the vasa nervorum using contrast‐enhanced ultrasound. J Neuroimaging 2017; 27(6): 583-8.
[http://dx.doi.org/10.1111/jon.12429] [PMID: 28195441]
[13]
Fields HL, Rowbotham M, Baron R. Postherpetic neuralgia: Irritable nociceptors and deafferentation. Neurobiol Dis 1998; 5(4): 209-27.
[http://dx.doi.org/10.1006/nbdi.1998.0204] [PMID: 9848092]
[14]
Choi JY, Kang CH, Kim BJ, Park KW, Yu SW. Brachial plexopathy following herpes zoster infection: Two cases with MRI findings. J Neurol Sci 2009; 285(1-2): 224-6.
[http://dx.doi.org/10.1016/j.jns.2009.05.016] [PMID: 19524942]
[15]
Egan C, Silverman E. Increased FDG uptake along dermatome on PET in a patient with herpes zoster. Clin Nucl Med 2013; 38(9): 744-5.
[http://dx.doi.org/10.1097/RLU.0b013e31829b2640] [PMID: 23816943]
[16]
Jeong J, Kim SW, Sung DH. Neurolymphomatosis: A single-center experience of neuromuscular manifestations, treatments, and outcomes. J Neurol 2021; 268(3): 851-9.
[http://dx.doi.org/10.1007/s00415-020-10202-0] [PMID: 33098033]
[17]
Shree R, Goyal MK, Modi M, et al. The diagnostic dilemma of neurolymphomatosis. J Clin Neurol 2016; 12(3): 274-81.
[http://dx.doi.org/10.3988/jcn.2016.12.3.274] [PMID: 27449910]