Clinical Pain

Korean Association of Pain Medicine (대한임상통증학회)
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Spinal Accessory Neuropathy Secondary to Diffuse Large B-Cell Lymphoma

미만성 거대 B세포 림프종으로 인한 척수더부신경병증

  • Kim, Kunwoo (Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Lee, Yong-Taek (Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Yoon, Kyung Jae (Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Lee, Jung-Sang (Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Hwang, Jin-Tae (Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Do, Jong Geol (Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • 김건우 (성균관대학교 의과대학 강북삼성병원 재활의학교실) ;
  • 이용택 (성균관대학교 의과대학 강북삼성병원 재활의학교실) ;
  • 윤경재 (성균관대학교 의과대학 강북삼성병원 재활의학교실) ;
  • 이정상 (성균관대학교 의과대학 강북삼성병원 재활의학교실) ;
  • 황진태 (성균관대학교 의과대학 강북삼성병원 재활의학교실) ;
  • 도종걸 (성균관대학교 의과대학 강북삼성병원 재활의학교실)
  • Received : 2018.11.18
  • Accepted : 2019.05.31
  • Published : 2019.06.30

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Abstract

Spinal accessory neuropathy (SAN) is commonly caused by an iatrogenic procedure, and that caused by tumors is very rare. We present a case of a 49-year-old man suffering from weakness in the right trapezius and sternocleidomastoid muscle. An electrophysiology study confirmed proximal SAN. Fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) revealed a diffuse large B-cell lymphoma compressing the right spinal accessory nerve. Ultrasonography showed definite atrophy on the trapezius and sternocleidomastoid muscles. In addition, post-chemotherapy FDG-PET/CT showed increased FDG uptake in the right upper trapezius, suggestive of denervation. This is the first report of SAN caused by direct compression by a diffuse large B-cell lymphoma, comprehensively assessed by an electrophysiology study, ultrasonography, and FDG-PET/CT.

Keywords