Teaching NeuroImages A Woman with Atypical Facial Pain Neurology Resident and Fellow Section.

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Presentation transcript:

Teaching NeuroImages A Woman with Atypical Facial Pain Neurology Resident and Fellow Section

Vignette A 70-year-old woman with a history of non-Hodgkin’s lymphoma, presented with left-sided facial pain. Initial MRI head was negative. A week later, she developed hypesthesia in a V3 distribution. Repeat MRI and CSF analysis were unrevealing. FDG-PET showed increased uptake along the left V3 branch of the trigeminal nerve and in the parotid gland Ultrasound-guided biopsy of the left parotid was diagnostic Michel Toledano et al

Imaging Michel Toledano et al

Diagnostic utility of FDG-PET in neurolymphomatosis Biopsy of the left parotid confirmed recurrent lymphoma. Neurolymphomatosis is a rare manifestation of hematologic disease and diagnosis is often delayed. 1 Our case illustrates the utility of FDG-PET in establishing the diagnosis of neurolymphomatosis when suspicion is high but MRI is unrevealing. 2 Michel Toledano et al