Ultrasound in the diagnosis of sciatic nerve neurolymphomatosis as the initial presentation of diffuse large B-cell lymphoma: case report and brief review
https://doi.org/10.24835/1607-0771-2022-3-63-76
Abstract
Extranodal diffuse large B-cell lymphoma characterized by any organ primary lesion, except for lymph nodes. The article presents a rare case of this disease with primary site in the sciatic nerve. Neurolymphomatosis is a process peripheral nerves, roots, and cranial nerves infiltration by the lymphoma cells. Ultrasound examination of the left sciatic nerve was performed in 67-years-old female patient with the use of Affinity 70 (Philips, Netherlands) with 4–18 MHz linear probe. A local intraneural fusiform, markedly hypoechoic lesion (9.5 × 2.3 × 3.5 cm), covering the entire cross-sectional area of the nerve was found at the level of the middle third of the thigh. The loss of a typical nerve ultrasound pattern, heterogeneity of the structure with linear anechoic (liquid) layers, and single signals in color Doppler imaging were revealed. Focal hyperechogenicity of tissue, corresponding to a desmoplastic reaction was found on the periphery of the lesion. Magnetic resonance imaging confirmed the presence of the intraneural mass. An open nerve biopsy showed the presence of diffuse large B-cell lymphoma. Six cycles of R-CHOP chemotherapy were performed with dynamic ultrasound assessment of the size and structure of the lesion in the intervals between them. Thus, ultrasound provides early diagnosis of focal lesion of peripheral nerves and suggests its nature at the initial stage of the diagnostic pathway.
About the Authors
M. G. Danilova
Evidence-Based Medicine Clinic Umka Family
Russian Federation
Russian Federation
Marina G. Danilova - M.D., Ph.D., Ultrasound Diagnostics Department
Rostov-on-Don
V. G. Saltykova
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
M.D., Ph.D., Professor, Diagnostic Ultrasound Division
Moscow
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For citations:
Danilova M.G., Saltykova V.G. Ultrasound in the diagnosis of sciatic nerve neurolymphomatosis as the initial presentation of diffuse large B-cell lymphoma: case report and brief review. Ultrasound & Functional Diagnostics. 2022;(3):63-76. (In Russ.) https://doi.org/10.24835/1607-0771-2022-3-63-76
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