Clin Pain.  2019 Jun;18(1):52-57. 10.0000/cp.2019.18.1.52.

Spinal Accessory Neuropathy Secondary to Diffuse Large B-Cell Lymphoma

• Kim K
• Lee YT
• Yoon KJ
• Lee JS
• Hwang JT
• Do JG

• KMID: 2452735
• DOI: http://doi.org/10.0000/cp.2019.18.1.52

Abstract

Spinal accessory neuropathy (SAN) is commonly caused by an iatrogenic procedure, and that caused by tumors is very rare. We present a case of a 49-year-old man suffering from weakness in the right trapezius and sternocleidomastoid muscle. An electrophysiology study confirmed proximal SAN. Fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) revealed a diffuse large B-cell lymphoma compressing the right spinal accessory nerve. Ultrasonography showed definite atrophy on the trapezius and sternocleidomastoid muscles. In addition, post-chemotherapy FDG-PET/CT showed increased FDG uptake in the right upper trapezius, suggestive of denervation. This is the first report of SAN caused by direct compression by a diffuse large B-cell lymphoma, comprehensively assessed by an electrophysiology study, ultrasonography, and FDG-PET/CT.

Keyword

Spinal accessory nerve; Lymphoma; Scapula winging

MeSH Terms

Accessory Nerve
Atrophy
B-Lymphocytes*
Denervation
Electrophysiology
Humans
Lymphoma
Lymphoma, B-Cell*
Middle Aged
Muscles
Superficial Back Muscles
Ultrasonography