Non-Hodgkin lymphoma relapse presenting as isolated neurolymphomatosis of the brachial plexus - A case report

Abstract

Neurolymphomatosis is a rare manifestation of non-Hodgkin's lymphoma (NHL) and is characterized by infiltration of the nerves by neoplastic lymphoid cells and is seen in up to 0.2% of all NHL cases. Diagnosing this syndrome is quite a challenge to the hematologists given the vague symptoms and signs and the low incidence. Newer imaging modalities such as positron emission tomography-computed tomography and magnetic resonance imaging have enabled early diagnosis with a sensitivity reaching up to 100%. Despite a variety of therapies reported in the literature for the treatment, the prognosis is very poor. We report a 46-year-old male diagnosed to have NHL-diffuse large B-cell lymphoma and treated with rituximab, cyclophosphamide, vincristine, and prednisolone (R-CHOP) therapy who presented with left brachial plexus neurolymphomatosis as the initial feature of disease relapse.