Imaging of neurolymphomatosis with 18F-FDG PET/CT: A case report and review of literature
10.11855/j.issn.0577-7402.2016.01.07
- Author:
Guo-Zheng WU
1
Author Information
1. PET-CT Center, 113 Hospital of PLA
- Publication Type:Journal Article
- Keywords:
Emission-computed;
Fluorodeoxyglucose F18;
Marek disease;
Tomography;
Tomography;
X-ray computed
- From:
Medical Journal of Chinese People's Liberation Army
2016;41(1):31-35
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of FDG PET-CT in the diagnosis of neurolymphomatosis (NL). Methods The clinical manifestation and FDG PET/CT imaging results in a patient with diffuse large B cell lymphoma accompanying peripheral neuropathy which was confirmed by pathological examination, were introduced. The images as shown by PET/CT were compared with the findings of traditional imaging including MRI and CT. Relevant literature was reviewed. Results A 38-year female patient complaining of left chest-back pain for 2 months came to hospital for treatment. An enhanced MRI of thoracic vertebrae showed osseous destruction on the left side of 4th thoracic vertebra and left posterior segment of 5th rib, and it was primarily diagnosed as a tumor. FDG PET/CT revealed a massively increased radioactive uptake in intervertebral foramen of left 4th, 5th thoracic vertebrae. The lesion was shown as an increase in uptake of radio-active substance along the left 5th intercostal nerve in the form of bundle or threads. A round-like nodule with increased radioactive uptake was observed in the left parasternal 2nd intercostal space. A CT-guided percutaneous needle biopsy of the nodule revealed a diffuse large B-cell lymphoma (A type). The lesion was shown to involve 4th, 5th thoracic vertebrae and left 5th intercostal nerve. It was diagnosed as NL. Repeated FDG PET imaging after chemotherapy showed normal radioactive distribution in the site of primary lesion area. Conclusions PET/CT is effective and sensitive in the diagnosis of NL, especially in patient with a history of malignant hematologic disease with clinical symptoms concerning peripheral nerve, accompanied by negative results with other examinations. Comparing with MRI, PET/CT can reveal involvement of peripheral nerve earlier, better reflect the degree of pathological condition, and reveal the number of nerves involved, as well as size and morphology of the lesion. It can reveal the active lesions of NL, and provide the target for needle biopsy.
