Progressive neurolymphomatosis with cutaneous disease: response in a patient with mycosis fungoides

Skeletal Radiol. 2013 Jul;42(7):1011-5. doi: 10.1007/s00256-013-1595-6. Epub 2013 Mar 27.

Abstract

Peripheral neurolymphomatosis is a rare manifestation of advanced lymphoproliferative disorders. It is often associated with B cell lymphomas and rarely with cutaneous T cell lymphomas, such as mycosis fungoides and Sézary syndrome. In this case report, we present a 78-year-old male with a long-standing history of mycosis fungoides. The patient initially presented with chronic peripheral neuropathy in an ulnar nerve distribution. After an unsuccessful ulnar nerve transposition, the ulnar nerve was re-explored and a mass consistent with diffuse lymphomatous infiltration was diagnosed. Magnetic resonance (MR) imaging of the left brachial plexus and later of the sacral plexus demonstrated diffuse thickening and peripheral nodularity in keeping with neurolymphomatosis. The patient's clinical course rapidly deteriorated thereafter and the patient succumbed to his disease. Although uncommon, neurolymphomatosis may be considered in patients with chronic peripheral neuropathy and an underlying history of a lymphoproliferative disorder. US and MR may serve as helpful non-invasive adjuncts in making the diagnosis and identifying sites for biopsy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Diagnosis, Differential
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Mycosis Fungoides / diagnostic imaging*
  • Mycosis Fungoides / pathology*
  • Nervous System Neoplasms / diagnostic imaging*
  • Nervous System Neoplasms / pathology
  • Skin Neoplasms / diagnostic imaging*
  • Skin Neoplasms / pathology*
  • Ultrasonography / methods