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Teaching Neuro Images A Woman with Atypical Facial Pain

Teaching Neuro Images 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.

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Teaching Neuro Images A Woman with Atypical Facial Pain

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  1. Teaching NeuroImagesA Woman with Atypical Facial Pain Neurology Resident and Fellow Section

  2. 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

  3. Imaging Michel Toledano et al

  4. 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

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