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Published in: Journal of Neurology 3/2021

01-03-2021 | Lymphoma | Original Communication

Neurolymphomatosis: a single-center experience of neuromuscular manifestations, treatments, and outcomes

Authors: Jisun Jeong, Sun Woong Kim, Duk Hyun Sung

Published in: Journal of Neurology | Issue 3/2021

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Abstract

Objectives

Neurolymphomatosis (NL) is a disease characterized by the infiltration of malignant lymphocytes into the peripheral nervous system. We report clinical features, radiographic findings, modes of treatment, and outcomes of patients with NL.

Methods

We retrospectively investigated patients with NL. We extracted data, including clinical features, magnetic resolution imaging (MRI), 18F-fludeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scans, cerebrospinal fluid cytology findings, the results of electrodiagnostic studies, as well as patient treatments and outcomes.

Results

Ten NL patients were identified. All patients reported pain/paresthesia and weakness in the affected area. The MRI scans were abnormal in eight out of nine patients with an enhancement of the spinal nerve root, plexus, peripheral nerve trunk, and cranial nerve. The FDG PET/CT scans were positive in all patients. Radiculopathy or radiculoplexopathy was the most common electrodiagnostic finding. Neurological improvement was observed in only three patients. The condition of the nine patients who underwent multimodality treatments for cancer eventually deteriorated and the patients died.

Conclusions

NL should be considered in the differential diagnosis of any type of neuropathy in patients with lymphoma. Because it could be confused with other neuropathies in lymphoma and various musculoskeletal diseases, a high index of suspicion and familiarity with clinical manifestation of NL are key. FDG PET/CT was the most sensitive diagnostic imaging modality to detect relevant neural invasion. The root within the spinal neural foramen was the most frequently affected neural structure. Early diagnosis of this rare neurologic manifestation of lymphoma may improve treatment outcomes.
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Metadata
Title
Neurolymphomatosis: a single-center experience of neuromuscular manifestations, treatments, and outcomes
Authors
Jisun Jeong
Sun Woong Kim
Duk Hyun Sung
Publication date
01-03-2021
Publisher
Springer Berlin Heidelberg
Keyword
Lymphoma
Published in
Journal of Neurology / Issue 3/2021
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-020-10202-0

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