Case Report: Neurolymphomatosis of the sciatic nerve as a presentation of relapsed diffuse large B-cell lymphoma. (PubMed, Front Oncol)
A 71-year-old man with systemic diffuse large B-cell lymphoma (DLBCL), histologically confirmed by gastric biopsy, developed progressive left-leg neuropathic pain, numbness, and foot drop during rituximab maintenance after achieving complete remission (CR)...Given the patient's age and risk of neurotoxicity, treatment with cyclophosphamide preconditioning followed by glofitamab plus obinutuzumab achieved rapid clinical improvement and partial remission (PR) on imaging...In this case, nerve US played a central role by demonstrating the characteristic "fried egg sign," localizing the lesion, and enabling US-CNB for tissue confirmation, while contrast-enhanced MRI and whole-body ^18F-FDG PET/CT provided complementary information on neural involvement and overall disease extent. An ultrasound-centered multimodal approach may help shorten time to diagnosis and facilitate timely treatment and neurological recovery.