B-cell peripheral neurolymphomatosis: MRI and 18F-FDG PET/CT imaging characteristics

Anthony H. DeVries, Benjamin M. Howe, Robert J. Spinner, Stephen Broski

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: To examine the MRI and 18F-FDG PET/CT imaging characteristics of peripheral neurolymphomatosis. Materials and methods: All institutional cases of neurolymphomatosis with an MRI or 18F-FDG PET/CT from 2000 to 2017 were retrospectively reviewed. Included cases were biopsy-proven neurolymphomatosis or lymphoma patients with clinical and imaging evidence of neurolymphomatosis that resolved after chemotherapy. Multiple imaging parameters and clinical characteristics were recorded. Results: There were 27 cases of B-cell neurolymphomatosis in 25 patients (18 M, 7 F; mean age 64.6 ± 10.0 years). Of the total cases, 85% (23/27) were biopsy-proven. Most were diagnosed after disease progression or recurrence (20/27, 74%), and presented with isolated nerve involvement (18/27, 67%). Bone marrow biopsy (17/19, 89%) and CSF cytology (16/23, 70%) were usually negative. On 18F-FDG PET/CT, neurolymphomatosis presented as a linear or fusiform (23/26, 88%), FDG-avid (average SUVmax: 7.1 ± 4.5, range, 1.5–17.0) mass, and on MRI as a T2-weighted hyperintense (21/22, 95%), enhancing (21/22, 95%), linear or fusiform mass (19/22, 86%), with associated muscle denervation (14/22, 64%). FDG avidity was significantly higher in patients with muscular denervation on MRI (mean SUVmax 8.2 ± 4.6 vs. 4.3 ± 2.3, p = 0.04). Conclusions: B-cell neurolymphomatosis most commonly manifests as T2-weighted hyperintense, enhancing linear or fusiform neural enlargement associated with muscular denervation on MRI, with intense FDG activity on PET/CT. It is most often an isolated site of disease, presenting after progression or recurrence. A familiarity with the imaging appearance of neurolymphomatosis can help refine the differential diagnosis, direct biopsy, and aid in accurate diagnosis.

Original languageEnglish (US)
JournalSkeletal Radiology
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Marek Disease
Fluorodeoxyglucose F18
B-Lymphocytes
Biopsy
Denervation
Muscle Denervation
Recurrence
Cell Biology
Disease Progression
Lymphoma
Differential Diagnosis
Bone Marrow
Drug Therapy

Keywords

  • FDG
  • Lymphoma
  • MRI
  • Neurolymphomatosis
  • Peripheral nerve
  • PET/CT

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

B-cell peripheral neurolymphomatosis : MRI and 18F-FDG PET/CT imaging characteristics. / DeVries, Anthony H.; Howe, Benjamin M.; Spinner, Robert J.; Broski, Stephen.

In: Skeletal Radiology, 01.01.2019.

Research output: Contribution to journalArticle

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title = "B-cell peripheral neurolymphomatosis: MRI and 18F-FDG PET/CT imaging characteristics",
abstract = "Objective: To examine the MRI and 18F-FDG PET/CT imaging characteristics of peripheral neurolymphomatosis. Materials and methods: All institutional cases of neurolymphomatosis with an MRI or 18F-FDG PET/CT from 2000 to 2017 were retrospectively reviewed. Included cases were biopsy-proven neurolymphomatosis or lymphoma patients with clinical and imaging evidence of neurolymphomatosis that resolved after chemotherapy. Multiple imaging parameters and clinical characteristics were recorded. Results: There were 27 cases of B-cell neurolymphomatosis in 25 patients (18 M, 7 F; mean age 64.6 ± 10.0 years). Of the total cases, 85{\%} (23/27) were biopsy-proven. Most were diagnosed after disease progression or recurrence (20/27, 74{\%}), and presented with isolated nerve involvement (18/27, 67{\%}). Bone marrow biopsy (17/19, 89{\%}) and CSF cytology (16/23, 70{\%}) were usually negative. On 18F-FDG PET/CT, neurolymphomatosis presented as a linear or fusiform (23/26, 88{\%}), FDG-avid (average SUVmax: 7.1 ± 4.5, range, 1.5–17.0) mass, and on MRI as a T2-weighted hyperintense (21/22, 95{\%}), enhancing (21/22, 95{\%}), linear or fusiform mass (19/22, 86{\%}), with associated muscle denervation (14/22, 64{\%}). FDG avidity was significantly higher in patients with muscular denervation on MRI (mean SUVmax 8.2 ± 4.6 vs. 4.3 ± 2.3, p = 0.04). Conclusions: B-cell neurolymphomatosis most commonly manifests as T2-weighted hyperintense, enhancing linear or fusiform neural enlargement associated with muscular denervation on MRI, with intense FDG activity on PET/CT. It is most often an isolated site of disease, presenting after progression or recurrence. A familiarity with the imaging appearance of neurolymphomatosis can help refine the differential diagnosis, direct biopsy, and aid in accurate diagnosis.",
keywords = "FDG, Lymphoma, MRI, Neurolymphomatosis, Peripheral nerve, PET/CT",
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T2 - MRI and 18F-FDG PET/CT imaging characteristics

AU - DeVries, Anthony H.

AU - Howe, Benjamin M.

AU - Spinner, Robert J.

AU - Broski, Stephen

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N2 - Objective: To examine the MRI and 18F-FDG PET/CT imaging characteristics of peripheral neurolymphomatosis. Materials and methods: All institutional cases of neurolymphomatosis with an MRI or 18F-FDG PET/CT from 2000 to 2017 were retrospectively reviewed. Included cases were biopsy-proven neurolymphomatosis or lymphoma patients with clinical and imaging evidence of neurolymphomatosis that resolved after chemotherapy. Multiple imaging parameters and clinical characteristics were recorded. Results: There were 27 cases of B-cell neurolymphomatosis in 25 patients (18 M, 7 F; mean age 64.6 ± 10.0 years). Of the total cases, 85% (23/27) were biopsy-proven. Most were diagnosed after disease progression or recurrence (20/27, 74%), and presented with isolated nerve involvement (18/27, 67%). Bone marrow biopsy (17/19, 89%) and CSF cytology (16/23, 70%) were usually negative. On 18F-FDG PET/CT, neurolymphomatosis presented as a linear or fusiform (23/26, 88%), FDG-avid (average SUVmax: 7.1 ± 4.5, range, 1.5–17.0) mass, and on MRI as a T2-weighted hyperintense (21/22, 95%), enhancing (21/22, 95%), linear or fusiform mass (19/22, 86%), with associated muscle denervation (14/22, 64%). FDG avidity was significantly higher in patients with muscular denervation on MRI (mean SUVmax 8.2 ± 4.6 vs. 4.3 ± 2.3, p = 0.04). Conclusions: B-cell neurolymphomatosis most commonly manifests as T2-weighted hyperintense, enhancing linear or fusiform neural enlargement associated with muscular denervation on MRI, with intense FDG activity on PET/CT. It is most often an isolated site of disease, presenting after progression or recurrence. A familiarity with the imaging appearance of neurolymphomatosis can help refine the differential diagnosis, direct biopsy, and aid in accurate diagnosis.

AB - Objective: To examine the MRI and 18F-FDG PET/CT imaging characteristics of peripheral neurolymphomatosis. Materials and methods: All institutional cases of neurolymphomatosis with an MRI or 18F-FDG PET/CT from 2000 to 2017 were retrospectively reviewed. Included cases were biopsy-proven neurolymphomatosis or lymphoma patients with clinical and imaging evidence of neurolymphomatosis that resolved after chemotherapy. Multiple imaging parameters and clinical characteristics were recorded. Results: There were 27 cases of B-cell neurolymphomatosis in 25 patients (18 M, 7 F; mean age 64.6 ± 10.0 years). Of the total cases, 85% (23/27) were biopsy-proven. Most were diagnosed after disease progression or recurrence (20/27, 74%), and presented with isolated nerve involvement (18/27, 67%). Bone marrow biopsy (17/19, 89%) and CSF cytology (16/23, 70%) were usually negative. On 18F-FDG PET/CT, neurolymphomatosis presented as a linear or fusiform (23/26, 88%), FDG-avid (average SUVmax: 7.1 ± 4.5, range, 1.5–17.0) mass, and on MRI as a T2-weighted hyperintense (21/22, 95%), enhancing (21/22, 95%), linear or fusiform mass (19/22, 86%), with associated muscle denervation (14/22, 64%). FDG avidity was significantly higher in patients with muscular denervation on MRI (mean SUVmax 8.2 ± 4.6 vs. 4.3 ± 2.3, p = 0.04). Conclusions: B-cell neurolymphomatosis most commonly manifests as T2-weighted hyperintense, enhancing linear or fusiform neural enlargement associated with muscular denervation on MRI, with intense FDG activity on PET/CT. It is most often an isolated site of disease, presenting after progression or recurrence. A familiarity with the imaging appearance of neurolymphomatosis can help refine the differential diagnosis, direct biopsy, and aid in accurate diagnosis.

KW - FDG

KW - Lymphoma

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KW - Neurolymphomatosis

KW - Peripheral nerve

KW - PET/CT

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