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| LETTER TO EDITOR | | | | | Year : 2008 | Volume : 56 | Issue : 4 | Page : 485-486 | MRI diagnosis of neurolymphomatosis of the brachial plexus
Arti Chaturvedi, JP Singh, Vikas Rastogi
Department of Radiodiagnosis, Command Hospital Air Force, Bangalore, India
| Date of Acceptance | 05-Sep-2008 | Correspondence Address:
Arti Chaturvedi
Department of Radiodiagnosis, Command Hospital Air Force, Bangalore
India
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DOI: 10.4103/0028-3886.44817 PMID: 19127051
How to cite this article:
Chaturvedi A, Singh J P, Rastogi V. MRI diagnosis of neurolymphomatosis of the brachial plexus. Neurol India 2008;56:485-6 |
Sir,
Neurolymphomatosis (NL) is a rare manifestation of lymphoma which is characterized by selective infiltration of cranial and peripheral nerves and roots by lymphoma cells. [1] We present the classical magnetic resonance imaging (MRI) findings of brachial plexopathy in a 15-year-old boy with Non-Hodgkin's Lymphoma (NHL) who presented with right arm weakness six months after complete remission.
MRI of the brachial plexus demonstrated thickening and hyperintensity of the C5 root and upper trunk of the right brachial plexus. There was also hyperintensity of the adjacent spinal cord [Figure 1A] and [Figure 1B]. Post Gadolinium images showed significant contrast enhancement of the involved trunk, nerve root and the spinal cord at C4-5 level [Figure 2] and [Figure 3]. A concomitant CSF examination revealed the presence of multiple, abnormal B-cell lymphocytes. In view of these typical MRI and CSF findings, a diagnosis of B-cell neurolymphomatosis involving the right brachial plexus was made and the patient was started on salvage chemotherapy.
Patients of NL commonly present with a progressive sensorimotor peripheral neuropathy, plexopathy or cranial neuropathy. A histopathological demonstration of malignant lymphocytes in the peripheral nerves is the gold standard for diagnosis but a biopsy may not always be possible or positive. [2] In such situations, MRI can be of immense diagnostic value by demonstrating diffuse neural thickening and enhancement and thus enabling an early diagnosis of NL. [1],[3]
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| 1. | Baehring JM, Damek D, Martin EC, Betensky RA, Hochberg FH. Neurolymphomatosis. Neuro Oncol 2003;5:104-15.  [PUBMED] [FULLTEXT] | | 2. | Shibata-Hamaguchi A, Samuraki M, Furui E, Ishida C, Kitagawa S, Nakao S, et al . B-cell neurolymphomatosis confined to the peripheral nervous system. J Neurol Sci 2007;260:249-52. [PUBMED] [FULLTEXT] | | 3. | Swarnkar A, Fukui MB, Fink DJ, Rao GR. MR imaging of brachial plexopathy in neurolymphomatosis. AJR Am J Roentgenol 1997;169:1189-90. [PUBMED] [FULLTEXT] |
[Figure 1A], [Figure 1B], [Figure 2], [Figure 3]
| This article has been cited by | | 1 | High-Resolution 3T MR Neurography of the Brachial Plexus and Its Branches, with Emphasis on 3D Imaging | | | A. Chhabra, G. K. Thawait, T. Soldatos, R. S. Thakkar, F. D. Grande, M. Chalian, J. A. Carrino | | American Journal of Neuroradiology. 2013; 34(3): 486 | | [VIEW] | | | 2 | Increasing importance of 18F-FDG PET in the diagnosis of neurolymphomatosis | | | Liesbeth P. Salm,Bernies Van der Hiel,Marcel P.M. Stokkel | | Nuclear Medicine Communications. 2012; 33(9): 907 | | [Pubmed] | | | 3 | Increasing importance of 18F-FDG PET in the diagnosis of neurolymphomatosis | | | Salm, L.P. and Van Der Hiel, B. and Stokkel, M.P.M. | | Nuclear Medicine Communications. 2012; 33(9): 907-916 | | [Pubmed] | |
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