Neurolymphomatosis (NL) is defined as the involvement of the peripheral nervous system in lymphocytic invasion. It is a very rare form of lymphoma that may occur as an initial presentation or recurrence. It affects various peripheral nervous structures and can therefore mimic disc-related nerve root pathology or compressive mononeuropathy. NL often occurs in malignant B-cell non-Hodgkin lymphomas. Notwithstanding its aggressiveness or intractability, NL should be discriminated from other neurologic complications of lymphoma. Herein, we present a case of primary NL as the initial presentation of diffuse large B-cell lymphoma (DLBCL) of the sciatic nerve. The patient presented with weakness and pain in his left leg but had no obvious lesion explaining the neurologic deficit on initial lumbosacral and knee magnetic resonance imaging (MRI). NL of the left sciatic nerve at the greater sciatic foramen was diagnosed based on subsequent hip MRI, electrodiagnostic test, positron emission tomography/computed tomography, and nerve biopsy findings. Leg weakness slightly improved after chemotherapy and radiotherapy. We report a case wherein NL, a rare cause of leg weakness, manifested as the initial presentation of primary DLBCL involving the sciatic nerve at the greater sciatic foramen.
Keyphrases
- diffuse large b cell lymphoma
- computed tomography
- positron emission tomography
- magnetic resonance imaging
- epstein barr virus
- contrast enhanced
- case report
- peripheral nerve
- neuropathic pain
- chronic pain
- locally advanced
- diffusion weighted imaging
- radiation therapy
- early stage
- pain management
- radiation induced
- magnetic resonance
- pet ct
- spinal cord injury
- dual energy
- pet imaging
- spinal cord
- fine needle aspiration
- postoperative pain