Solitary sciatic nerve lymphoma as an initial manifestation of diffuse neurolymphomatosis

Alfredo Quinones-Hinojosa, Robert M. Friedlander, Philip J. Boyer, Tracy T. Batchelor, E. Antonio Chiocca

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Solitary peripheral nerve lymphomas are exceedingly rare primary manifestations of diffuse peripheral nervous system or central nervous system (CNS) lymphomatosis. A 52-year-old man presented with progressive weakness in gastrocnemius and anterior tibial muscle function, which was associated with radiating pain in the right leg. Magnetic resonance imaging studies revealed a solitary fusiform tumor, extending from the sciatic nerve, at the level of the lesser trochanter of the femur, into the posterior tibial nerve below the popliteal fossa. Intraoperative gross examination found that the tumor diffusely expanded the nerve, but did not extend from or into surrounding muscle or tendons. The final histological diagnosis was a solitary extranodal lymphoma (Burkittlike high-grade B-cell lymphoma). Postoperative staging did not reveal evidence of lymphomatous involvement of other organs, but additional chemo- and radiotherapies were administered. Four months after the surgical biopsy, the patient presented with a right facial nerve palsy. The results of cytological examination of cerebrospinal fluid were positive for the presence of atypical lymphocytes, which was consistent with apparently progressive neurolymphomatosis; however, the results of radiological studies were negative for systemic progression. The patient underwent intrathecal chemotherapy followed by systemic myelosuppressive chemotherapy with bone marrow rescue, but died of respiratory failure while still receiving treatment. Postmortem examination revealed extensive lymphomatosis in the peripheral nerves and spinal nerve roots without evidence of cranial nerve, CNS, or other organ system involvement. The aggressive biological characteristics of these tumors, their management, and pertinent literature are reviewed.

Original languageEnglish (US)
Pages (from-to)165-169
Number of pages5
JournalJournal of Neurosurgery
Volume92
Issue number1
StatePublished - Jan 2000
Externally publishedYes

Fingerprint

Marek Disease
Sciatic Nerve
Lymphoma
Peripheral Nerves
Drug Therapy
Femur
Central Nervous System
Neoplasms
Tibial Nerve
Cranial Nerves
Spinal Nerve Roots
Facial Paralysis
Facial Nerve
Peripheral Nervous System
B-Cell Lymphoma
Respiratory Insufficiency
Tendons
Non-Hodgkin's Lymphoma
Cerebrospinal Fluid
Autopsy

Keywords

  • Burkittlike lymphoma
  • Extranodal lymphoma
  • Neurolymphomatosis
  • Non- Hodgkin's lymphoma
  • Sciatic nerve

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)
  • Clinical Neurology

Cite this

Quinones-Hinojosa, A., Friedlander, R. M., Boyer, P. J., Batchelor, T. T., & Chiocca, E. A. (2000). Solitary sciatic nerve lymphoma as an initial manifestation of diffuse neurolymphomatosis. Journal of Neurosurgery, 92(1), 165-169.

Solitary sciatic nerve lymphoma as an initial manifestation of diffuse neurolymphomatosis. / Quinones-Hinojosa, Alfredo; Friedlander, Robert M.; Boyer, Philip J.; Batchelor, Tracy T.; Chiocca, E. Antonio.

In: Journal of Neurosurgery, Vol. 92, No. 1, 01.2000, p. 165-169.

Research output: Contribution to journalArticle

Quinones-Hinojosa, A, Friedlander, RM, Boyer, PJ, Batchelor, TT & Chiocca, EA 2000, 'Solitary sciatic nerve lymphoma as an initial manifestation of diffuse neurolymphomatosis', Journal of Neurosurgery, vol. 92, no. 1, pp. 165-169.
Quinones-Hinojosa, Alfredo ; Friedlander, Robert M. ; Boyer, Philip J. ; Batchelor, Tracy T. ; Chiocca, E. Antonio. / Solitary sciatic nerve lymphoma as an initial manifestation of diffuse neurolymphomatosis. In: Journal of Neurosurgery. 2000 ; Vol. 92, No. 1. pp. 165-169.
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