Neurolymphomatosis of the peripheral nervous system: a case report and review of the literature.

Neurolymphomatosis is a rare neurological syndrome in lymphomas. It is reported as infiltration of peripheral nerves by lymphoma. It is important to distinguish neurolymphomatosis from other types of neuropathies, particularly infectious and inflammatory conditions. However, it is difficult to isolate a cancer-related inflammatory vasculitis and mononeuritis multiplex without definitive histopathologic examination. In this report, we describe a case of non-Hodgkin's lymphoma involving the peroneal nerve and presenting as neurolymphomatosis.

Mycobacterial pseudotumor of the plantar fascia: how common is it?

Mycobacterial spindle cell pseudotumor (MSCP) is an extremely rare complication of mycobacterial infections. It has been reported to occur in various sites such as skin, lymph nodes, bone marrow, lungs, and spleen. This tumor-like lesion can be confused clinically as well as radiographically with dermatofibroma, nodular fasciitis, xanthogranuloma, and Kaposi's sarcoma. While this lesion is rare and has been previously reported to occur only in superficial skin, we emphasize its consideration and inclusion in the differential diagnoses when a deep soft tissue mass is complicated by symptoms of deep tissue infection secondary to abscess formation in immunocompromised hosts. Here, we present the clinical and radiologic findings of a case of MSCP involving the deep plantar sheaths.

Simultaneous presentation in the neck and abdomen of malignant peripheral nerve sheath tumors involving two different nerve tracts.

Neurofibromatosis-1 (NF-1) is a relatively common autosomal dominant disease and it is caused by mutation of the NF-1 tumor suppressor gene; hence, the individuals affected have increased risk for developing familial cancer. Abdominal cavity neurofibromas are common but the simultaneous occurrence of a malignant peripheral nerve sheath tumor (MPNST) in the chest and in the abdomen is rare. Here, we present a patient with MPNST (spindle cell sarcoma) affecting simultaneously the vagus nerve in the head and neck region, mediastinum, pleura as well as celiac plexus branches near the stomach.

Radionuclide therapy of painful bone metastases--a comparative study between consecutive radionuclide infusions, combination with chemotherapy, and radionuclide infusions alone: an in vivo comparison of their effectiveness.

Radionuclides have been long used for the palliation of skeletal-related metastatic pain. They are almost invariably used as the last resource for pain palliation. Their use as single agents with dose escalations, in combination with biphosphonates or chemotherapy is well known in the peer-reviewed literature; however, little is known about the combination between different agents. In our study, we used consecutive administration of 2 different radionuclides such as (186)Re-1,1-hydroxyethylidenediphosphonate ((186)Re-HEDP) and (89)Strontium Chloride ((89)Sr-Cl) separated by adequate period of time to allow bone marrow recovery in patients with high chance of bone pain relapse and compared it with (89)Sr-Cl and chemotherapy group and (186)Re-HEDP with bisphosphonates. The end result was that treatment with consecutive radionuclides was much more effective and safe than the other 2 groups.

Middle cerebral artery involvement in systemic lupus erythematosus presenting as a stroke--an unusual initial presentation of the disease.

Systemic lupus erythematosus (SLE) disproportionately affects the African American population and usually presents with a constellation of symptoms. Along with hematologic, musculoskeletal, serous and skin involvement, the most common causes of morbidity are attributed to altered blood rheology causing accelerated atherosclerotic vascular disease (ASVD). ASVD occurs in predominantly premenopausal women at an age where ASVD is rare or uncommon. Classical central nervous system manifestations are very rare from the outset of the disease. Here we present a 44-year old African American woman with newly diagnosed SLE and no significant atherosclerotic risk factors, who presented initially with symptoms of subacute stroke.

Superselective internal radiation with yttrium-90 microspheres in the management of a chemorefractory testicular liver metastasis.

We treated a patient with biopsy-proven, chemotherapy-resistant testicular cancer liver metastasis using Y-90 selective internal radiation treatment. We chose yttrium-90 rather than surgery and ablation due to tumor location and size as well as the patient's clinical history. The result was marked tumor response by positron emission tomography and computed tomography as well as significant improvement of the patient's quality of life accompanied by a substantial decrease of his tumor markers.

FDG PET/CT of extranodal involvement in non-Hodgkin lymphoma and Hodgkin disease.

The term extranodal disease refers to lymphomatous infiltration of anatomic sites other than the lymph nodes. Almost any organ can be affected by lymphoma, with the most common extranodal sites of involvement being the stomach, spleen, Waldeyer ring, central nervous system, lung, bone, and skin. The prevalence of extranodal involvement in non-Hodgkin lymphoma and Hodgkin disease has increased in the past decade. The imaging characteristics of extranodal involvement can be subtle or absent at conventional computed tomography (CT). Imaging of tumor metabolism with 2-[fluorine-18]fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) has facilitated the identification of affected extranodal sites, even when CT has demonstrated no lesions. More recently, hybrid PET/CT has become the standard imaging modality for initial staging, follow-up, and treatment response assessment in patients with lymphoma and has proved superior to CT in these settings. Certain PET/CT patterns are suggestive of extranodal disease and can help differentiate tumor from normal physiologic FDG activity, particularly in the mucosal tissues, bone marrow, and organs of the gastrointestinal tract. Familiarity with the different extranodal manifestations in various locations is critical for correct image interpretation. In addition, a knowledge of the differences in FDG avidity among the histologic subtypes of lymphoma, appropriate timing of scanning after therapeutic interventions, and use of techniques to prevent brown fat uptake are essential for providing the oncologist with accurate information.