Vol 27 (2024): Continuous Publishing
Clinical vignette
Published online: 2024-07-24

open access

Page views 522
Article views/downloads 323
Get Citation

Connect on Social Media

Connect on Social Media

Diffuse lymphoma involvement of the spinal cord showed on [18F]FDG PET/MRI

Chunyan Zhao1, Liqian Yu1, Lin Li1, Minggang Su1
Pubmed: 39046220
Nucl. Med. Rev 2024;27:24-27.

Abstract

A 61-year-old woman with diffuse large B-cell lymphoma received a fluorine-18-deoxyglucose positron emission tomography/computed tomography ([18F]FDG PET/CT) for staging. Because of the obvious uptake of [18F]FDG in the spinal cord and brain, a positron emission tomography/magnetic resonance imaging (PET/MRI) was performed after the positron emission tomography/computed tomography (PET/CT). The images showed diffuse [18F]FDG uptake of the spinal cord and increased T2 signal intensity on MRI, which was suspected to be lymphoma involvement. The patient was diagnosed with diffuse large B-cell lymphoma involving the right maxillofacial region, right cervical lymph nodes, cervix, brain and spinal cord (stage IV of non-germinal center B-cell origin). After chemotherapy, the spinal [18F]FDG uptake level decreased significantly, which was considered to be a partial metabolic response. Our case was different from prior, which indicated the pattern of spinal cord involvement by lymphoma was focal.

Article available in PDF format

View PDF Download PDF file

References

  1. Rao A, Griffiths R, Arnaoutakis K. Paralyzed by a rare cause: an unusual case of metastatic diffuse large B cell lymphoma of the intramedullary spinal cord. Ann Hematol. 2014; 93(2): 337–338.
  2. Ban Y, Jing Z, Zou J. Multiple secondary cauda equina non-Hodgkin's lymphoma: a case report and literature review. BMC Cancer. 2019; 19(1): 594.
  3. Fleury I, Amorim S, Mounier N, et al. Management and prognosis of 66 patients with B-cell non-Hodgkin lymphoma presenting with initial spinal cord compression: a French retrospective multicenter study. Leuk Lymphoma. 2015; 56(7): 2025–2031.
  4. Zagami AS, Granot R. Non-Hodgkin's lymphoma involving the cauda equina and ocular cranial nerves: case reports and literature review. J Clin Neurosci. 2003; 10(6): 696–699.
  5. Broen M, Draak T, Riedl RG, et al. Diffuse large B-cell lymphoma of the cauda equina. BMJ Case Rep. 2014; 2014.
  6. Gheysens O, Deroose CM, Tousseyn T, et al. Hodgkin lymphoma-associated paraneoplastic cerebellar degeneration on FDG-PET/CT. Br J Haematol. 2014; 164(4): 468.
  7. Madhavan AA, Carr CM, Morris PP, et al. Imaging review of paraneoplastic neurologic syndromes. AJNR Am J Neuroradiol. 2020; 41(12): 2176–2187.
  8. Hammack J, Kotanides H, Rosenblum MK, et al. Paraneoplastic cerebellar degeneration. II. Clinical and immunologic findings in 21 patients with Hodgkin's disease. Neurology. 1992; 42(10): 1938–1943.
  9. Aiello M, Alfano V, Salvatore E, et al. [F]FDG uptake of the normal spinal cord in PET/MR imaging: comparison with PET/CT imaging. EJNMMI Res. 2020; 10(1): 91.
  10. Nishida H, Hori M, Obara K. Primary B-cell lymphoma of the cauda equina, successfully treated with high-dose methotrexate plus high-dose cytarabine: a case report with MRI findings. Neurol Sci. 2012; 33(2): 403–407.
  11. Teo MK, Mathieson C, Carruthers R, et al. Cauda equina lymphoma — a rare presentation of primary central nervous system lymphoma: case report and literature review. Br J Neurosurg. 2012; 26(6): 868–871.
  12. Nakajima H, Motomura M, Yamaguchi M, et al. [Leptomeningeal infiltlation of primary CNS B-cell lymphoma diagnosed by the biopsy of cauda equina: a case report]. Rinsho Shinkeigaku. 2013; 53(10): 803–808.