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Skeletal Radiology
Published in: Skeletal Radiology 7/2019

01-07-2019 | Lymphoma | Scientific Article

B-cell peripheral neurolymphomatosis: MRI and 18F-FDG PET/CT imaging characteristics

Authors: Anthony H. DeVries, Benjamin M. Howe, Robert J. Spinner, Stephen M. Broski

Published in: Skeletal Radiology | Issue 7/2019

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Abstract

Objective

To examine the MRI and 18F-FDG PET/CT imaging characteristics of peripheral neurolymphomatosis.

Materials and methods

All institutional cases of neurolymphomatosis with an MRI or 18F-FDG PET/CT from 2000 to 2017 were retrospectively reviewed. Included cases were biopsy-proven neurolymphomatosis or lymphoma patients with clinical and imaging evidence of neurolymphomatosis that resolved after chemotherapy. Multiple imaging parameters and clinical characteristics were recorded.

Results

There were 27 cases of B-cell neurolymphomatosis in 25 patients (18 M, 7 F; mean age 64.6 ± 10.0 years). Of the total cases, 85% (23/27) were biopsy-proven. Most were diagnosed after disease progression or recurrence (20/27, 74%), and presented with isolated nerve involvement (18/27, 67%). Bone marrow biopsy (17/19, 89%) and CSF cytology (16/23, 70%) were usually negative. On 18F-FDG PET/CT, neurolymphomatosis presented as a linear or fusiform (23/26, 88%), FDG-avid (average SUVmax: 7.1 ± 4.5, range, 1.5–17.0) mass, and on MRI as a T2-weighted hyperintense (21/22, 95%), enhancing (21/22, 95%), linear or fusiform mass (19/22, 86%), with associated muscle denervation (14/22, 64%). FDG avidity was significantly higher in patients with muscular denervation on MRI (mean SUVmax 8.2 ± 4.6 vs. 4.3 ± 2.3, p = 0.04).

Conclusions

B-cell neurolymphomatosis most commonly manifests as T2-weighted hyperintense, enhancing linear or fusiform neural enlargement associated with muscular denervation on MRI, with intense FDG activity on PET/CT. It is most often an isolated site of disease, presenting after progression or recurrence. A familiarity with the imaging appearance of neurolymphomatosis can help refine the differential diagnosis, direct biopsy, and aid in accurate diagnosis.
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Metadata
Title
B-cell peripheral neurolymphomatosis: MRI and 18F-FDG PET/CT imaging characteristics
Authors
Anthony H. DeVries
Benjamin M. Howe
Robert J. Spinner
Stephen M. Broski
Publication date
01-07-2019
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 7/2019
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-019-3145-3

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