Neurolymphomatosis Involving Sciatic Nerve - A Case Report -

Ki-Ser Kang; Eun Woo Lee; Ho-Joong Jung; Young-Bok Jung; Eui-Chan Jang; Kwang-Sup Song; Jae-Hyun Yoo

doi:10.4055/jkoa.2007.42.5.679

Journal List > J Korean Orthop Assoc > v.42(5) > 1012715

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kang, Lee, Jung, Jung, Jang, Song, and Yoo: Neurolymphomatosis Involving Sciatic Nerve - A Case Report -

Case Report

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2007; 42(5): 679-683.

Published online: 31 October 2007

DOI: https://doi.org/10.4055/jkoa.2007.42.5.679

Neurolymphomatosis Involving Sciatic Nerve - A Case Report -

Ki-Ser Kang, M.D., Eun Woo Lee, M.D., Ho-Joong Jung, M.D., Young-Bok Jung, M.D., Eui-Chan Jang, M.D., Kwang-Sup Song, M.D., Jae-Hyun Yoo, M.D.

Department of Orthopaedic Surgery, Medical Center of Chung-Ang University, Seoul, Korea.

Address reprint requests to Ho-Joong Jung, M.D. Department of Orthopaedic Surgery, Medical Center of Chung-Ang University, 224-1, Heukseok-dong, Dongjak-gu, Seoul 156-755, Korea. Tel: +82.2-6299-1588, Fax: +82.2-822-1710, sunu@cau.ac.kr

Abstract

The term "Neurolymphomatosis" includes the infiltration of the peripheral nervous system by lymphoma and nontumor lymphocytes. A neurolymphomatosis has not been classified as a distinct entity. Hence, its characteristic symptoms are often missed, and oncologists or neurological consultants fail to obtain an accurate diagnoses. We encountered a case of non-Hodgkins lymphoma involving the sciatic nerve, which has never been reported in the orthopedic literature in Korea. We report a case of neurolymphomatosis with a brief review of the literature.

Keywords: Neurolymphomatosis, Lymphoma, Sciatic nerve

Figures and Tables

Fig. 1

(A, B) Axial MR image of the distal femur shows that a diffuse enlarged sciatic nerve (arrow head) appears to invade and surround the involved nerve. Epineurium and perineurium of the sciatic nerve shows an iso-signal in the T1 images and a high-signal in the T2 images. Diffuse enhancement of lesion suggests nerve infiltration of the lymphoma. (C) T1 axial fat suppression Gd enhancement at the proximal femur. (D) T1 axial fat suppression Gd enhancement at the distal femur.

Fig. 2

(A) Enlarged lymph node is shown beside the peroneal nerve (black arrow). The peroneal nerve appears normal (white arrow), but the enlarged tibial nerve portion of the sciatic nerve occupies 4/5 of the sciatic nerve. (B) After removing the epineurium, diffuse infiltrations of tumor cells were observed between the nerve fascicle, which showed axonal degeneration.

Fig. 3

Malignant lymphoma invades the peripheral nerve. Large lymphoid cells are present with pleomorphic, often with horseshoe-shaped nuclei, and abundant cytoplasm.

Fig. 4

Anaplastic large cell lymphoma with the involvement of the soft tissue, an unlabeled muscle, tibia nerve LCA (+), T-cell (+), Ki-1 (+), B-cell (-).

References

1. Baehring JM, Damek D, Martin EC, Betensky RA, Hochberg FH. Neurolymphomatosis. Neuro Oncol. 2003. 5:104–115.

2. Byun WM, Park WK, Park BH, Ahn SH, Hwang MS, Chang JC. Guillain-Barré syndrome: MR imaging findings of the spine in eight patients. Radiology. 1998. 208:137–141.

3. Currie S, Henson RA. Neurological syndromes in the reticuloses. Brain. 1971. 94:307–320.

4. Harris NL, Jaffe ES, Diebold J, Flandrin G, Muller-Hermelink HK, Vardiman J. Lymphoma classification--from controversy to consensus: the R.E.A.L. and WHO Classification of lymphoid neoplasms. Ann Oncol. 2000. 11:Suppl 1. 3–10.

5. Hoerni-Simon G, Suchaud JP, Eghbali H, Coindre JM, Hoerni B. Secondary involvement of the central nervous system in malignant non-Hodgkin's lymphoma. A study of 30 cases in a series of 498 patients. Oncology. 1987. 44:98–101.

6. Kajiya Y, Nakajo M, Kajiya Y, Miyaji N. Oculomotor nerve invasion by lymphoma demonstrated by MRI. J Comput Assist Tomogr. 1995. 19:502–504.

7. Manon-Espaillat R, Lanska DJ, Ruff RL, Masaryk T. Visualization of isolated trigeminal nerve invasion by lymphoma using gadolinium-enhanced magnetic resonance imaging. Neuroradiology. 1990. 32:531–532.

8. Recht LD. Neurologic complications of systemic lymphoma. Neurol Clin. 1991. 9:1001–1015.

9. Richmond J, Sherman RS, Diamond HD, Craver LF. Renal lesions associated with malignant lymphomas. Am J Med. 1962. 32:184–207.

10. Young RC, Howser DM, Anderson T, Fisher RI, Jaffe E, DeVita VT. Central nervous system complications of non-Hodgkin's lymphoma. The potential role for prophylactic therapy. Am J Med. 1979. 66:435–443.

TOOLS

Similar articles