Figure/Graphic 1a-c: Mantle cell lymphoma
A 54-year-old man with a history of mantle cell lymphoma presented with tingling along the palmar surface of his left thumb. Then the left thumb, first and second digit started feeling “inflamed, swollen, about to explode”. The pain awakened him at night. At the same time, he felt a burning pain along the heel, lateral and anterior plantar surface of the right foot. Work-up revealed neurolymphomatosis. Multiple mass lesions were identified within the peripheral nervous system including the left sciatic nerve ([a, b] 18-FDG-PET), the left median nerve (arrow head in [c]; axial T1-weighted MRI of the left forearm; note infiltration of the flexor musculature by tumour), right brachial plexus, right sciatic nerve, and left tibial nerve (not shown). Biopsy of the soft tissue mass in the right forearm revealed a mantle cell lymphoma. R: radius; U: ulna