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C-0298 - Perineural spread of lymphoma: a review of the unusual disease distribution

J. Lee, S. Bhuva, M. Subesinghe, N. J. Taylor, C. A. Johnson; Oxford/UK Type: Educational Exhibit
Area of Interests: Oncology, Neuroradiology peripheral nerve, Lymph nodes
Imaging Techniques: PET-CT, MR
Procedure: Staging
Special Focuses: Lymphoma, Cancer
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Learning objectives: Perineural spread of disease is rare. However, where it occurs, perineural spread of disease may be a devastating manifestation of lymphoma. This paper explores the perineural spread of lymphoma, which may occur in isolation without other sites of nodal or extra nodal disease. 

Background: Perineural spread of disease is rare, but is most commonly encountered in the head and in the neck along branching cranial nerves. However, in cases where perineural spread of disease is a manifestation of lymphoma, perineural involvement can be seen almost anywhere in the human body. It i[...]

Findings and procedure details: The imaging signs of perineural spread of lymphoma can be classified as direct or indirect signs. Direct signs of perineural spread include increased prominence of the nerve; with thickening and irregularity and avid enhancement of the involved nerve. This is best demonstrated on isotropic volumet[...]

Conclusion: Perineural spread of disease in lymphoma is less common than the typical nodal masses and splenomegaly. Perineural spread of disease has acute and chronic sequelae. Recognition of perineural spread of disease on imaging is important as it has a poor prognosis and would change the management of dise[...]

Personal information: Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom

References: 1. Perineural Spread in Head and Neck Malignancies: Clinical Significance and Evaluation with 18F-FDG PET/CT. Fabio M. Paes, Adam D. Singer, Adam N. Checkver, Ricardo A. Palmquist, Gabriela De La Vega, and Charif Sidani. RadioGraphics 2013 33:6, 1717-1736. 2. Perineural sparead along trigeminal[...]

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