Clinical Pain

Korean Association of Pain Medicine (대한임상통증학회)
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When We Consider Neurolymphomatosis in Patient with Lumbosacral Plexopathy with an Extreme Leg Pain?

통증을 동반한 신경총병증에서 언제 신경림프종증을 고려해야 하는가?

  • Ahn, Jun Young (Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Seok, Hyun (Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Kim, Sang-Hyun (Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Kim, Hyun Jung (Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Cho, Yeon Hee (Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Oh, Back Min (Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Lee, Seung Yeol (Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine)
  • 안준영 (순천향대학교 의과대학 순천향대학교 부천병원 재활의학교실) ;
  • 석현 (순천향대학교 의과대학 순천향대학교 부천병원 재활의학교실) ;
  • 김상현 (순천향대학교 의과대학 순천향대학교 부천병원 재활의학교실) ;
  • 김현정 (순천향대학교 의과대학 순천향대학교 부천병원 재활의학교실) ;
  • 조연희 (순천향대학교 의과대학 순천향대학교 부천병원 재활의학교실) ;
  • 오백민 (순천향대학교 의과대학 순천향대학교 부천병원 재활의학교실) ;
  • 이승열 (순천향대학교 의과대학 순천향대학교 부천병원 재활의학교실)
  • Received : 2021.04.23
  • Accepted : 2021.06.01
  • Published : 2021.06.30
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Abstract

We report a case of neurolymphomatosis of lumbosacral plexus. A 63-year-old man, who had no past history except for diabetes mellitus, complained of severe pain and weakness on left lower extremity. Idiopathic lumbosacral plexopathy was diagnosed by electromyography. There were no abnormal findings except for FDG-PET/CT and MRI. They showed high uptake and thickening lesion in sciatic nerve and sacral plexus. However, about 7 months later, mass like lesion in left thigh was detected by FDG-PET/CT and MRI. Also, multiple hypermetabolic lesions were found in brain. Through brain biopsy, diffuse large B-cell lymphoma was confirmed. When a patient with idiopathic lumbosacral plexopathy complains of severe pain, it is necessary to consider FDG-PET/CT and MRI to differentiate neurolymphomatosis, even in patients who have no past history of lymphoma before. Especially, if FDG-PET/CT and MRI show sciatic and/or lumbosacral plexus lesion, neurolymphomatosis of lumbosacral plexus should be considered.

Keywords

Acknowledgement

This work was supported by the Soonchunhyang University Research Fund.

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