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Objective The diagnosis of peripheral neurolymphomatosis (NL) is difficult and often delayed, since patients can have isolated, non-specific nerve symptoms. Magnetic resonance imaging usually shows non-specific findings of enlarged, contrast-enhancing nerves. We aim to elucidate the mechanism behind an imaging finding that we believe is pathognomonic of this disease and likely of other hematologic diseases with peripheral nerve involvement. Methods We reviewed imaging studies of a previously published cohort of patients, in addition to m