A case report of primary central nervous system lymphoma with intestinal obstruction as the initial symptom

Li, Xiaoke; Qi, Shuo; Jiao, Yuntao; Gao, Jing; Du, Hongbo

doi:10.1097/md.0000000000010080

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…The 21 selected studies 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 that met the eligibility criteria are described in Table 1 , reporting a total of 25 cases (20 male and 5 female patients), in the age range of 15 to 79 years (average: 52.72 years). Only 10 cases reported follow-up as 4 patients were lost to follow-up and 11 studies did not report it.…”

Section: Resultsmentioning

confidence: 99%

B-Cell Lymphoma Intramedullary Tumor: Case Report and Systematic Review

Gonsalves¹,

Raffa²,

Sousa

et al. 2023

Asian J Neurosurg

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Intramedullary tumors represent the major cause of spinal cord injuries, and its symptoms include pain and weakness. Progressive weakness may concomitantly occur in the upper and lower limbs, along with lack of balance, spine tenderness, sensory loss, trophic changes of extremity, hyperreflexia, and clonus. The study protocol was in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A systematic search of the MEDLINE electronic database was performed to identify the studies reporting the clinical features of children and adults who presented with an intramedullary lymphoma. Twenty-one studies were included, reporting 25 cases. Manuscripts were excluded if the full-text article was not available, original data were not reported (e.g., review articles), or if the main disease was not intramedullary lymphoma. A structured data extraction form was employed to standardize the identification and retrieval of data from manuscripts. To enlighten the discussion, a case is also presented. An 82-year-old woman with Fitzpatrick skin type II, diagnosed and treated for non-Hodgkin's lymphoma 7 years ago, was admitted with mental confusion and memory loss for the past 2 months—evolving with recurring falls from her own height. One day before admission, she displayed Brown-Séquard syndrome. An expansive lesion from C2 to C4 in the cervical spinal cord was found and a hypersignal spinal cord adjacent was described at the bulb medullary transition to the C6–C7 level. A primary spinal cord tumor was considered, as well as a melanoma metastasis, due to the lesion's flame pattern. The patient presented a partial recovery of symptoms and a reduction of the spinal cord edema after being empirically treated with corticosteroids, but the lesion maintained its extent. Subsequently, a large diffuse B-cell lymphoma with nongerminal center was found in open body biopsy, infiltrating neural tissue. The main objective of the present study is to report a surgical case treated for a large diffuse B-cell lymphoma, in addition to presenting the results of a systematic review of primary intramedullary spinal cord lymphoma.

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Section: Resultsmentioning

confidence: 99%

B-Cell Lymphoma Intramedullary Tumor: Case Report and Systematic Review

Gonsalves¹,

Raffa²,

Sousa

et al. 2023

Asian J Neurosurg

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“…A total of 65 studies 3,13,17,30–91 with 72 cases of primary spinal B-cell lymphoma were included (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

Surgical Intervention for Primary B-cell Lymphoma of the Spine

Gendreau,

Patel,

Brown

et al. 2023

Clinical Spine Surgery: A Spine Publication

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Study Design: Systematic review and meta-analysis. Objective: To perform a systematic review of the clinical symptoms, radiographic findings, and outcomes after spinal decompression in B-cell lymphoma. Summary of Background Data: B-cell lymphoma is a potential cause of spinal cord compression that presents ambiguously with nonspecific symptoms and variable imaging findings. Surgical decompression is a mainstay for both diagnosis and management, especially in patients with acute neurological deficits; however, the efficacy of surgical intervention compared with nonoperative management is still unclear. Methods: The databases of Medline, PubMed, and the Cochrane Database of Systemic Reviews were queried for all articles reporting spinal B-cell lymphoma. Data on presenting symptoms, treatments, survival outcomes, and histologic markers were extracted. Using the R software “survival” package, we generated bivariate and multivariate Cox survival regression models and Kaplan-Meier curves. Results: In total, 65 studies were included with 72 patients diagnosed with spinal B-cell lymphoma. The mean age was 56.22 (interquartile range: 45.00–70.25) with 68% of patients being males and 4.2% of patients being immunocompromised. Back pain was the most common symptom (74%), whereas B symptoms and cauda equina symptoms were present in 6% and 29%, respectively. The average duration of symptoms before presentation was 3.81 months (interquartile range: 0.45–3.25). The most common location was the thoracic spine (53%), with most lesions being hyperintense (28%) on T2 magnetic resonance imaging. Surgical resection was performed in 83% of patients. Symptoms improved in 91% of patients after surgery and in 80% of patients treated nonoperatively. For all 72 patients, the overall survival at 1 and 5 years was 85% (95% CI: 0.749–0.953; n = 72) and 66% (95% CI: 0.512–0.847; n = 72), respectively. Conclusion: Although surgery is usually offered in patients with acute spinal cord compression from B-cell lymphoma, chemotherapy and radiation alone offer a hopeful alternative to achieve symptomatic relief, particularly in patients who are unable to undergo surgery.

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“…Because the etiology and pathogenesis of ANE are unclear, it is necessary before diagnosis to exclude HSV encephalitis [7], epidemic Japanese encephalitis [8], acute disseminated meningomyelitis [9], intracranial venous system thrombosis (especially Galen vein thrombosis) [10], tumor [11], poisoning, metabolic disease, and stroke. The two cases reported in this study were elderly males who experienced an onset of fever in the winter, followed by rapidly progressing central nervous system symptoms such as poor speech, slow response, and limb weakness.…”

Section: Discussionmentioning

confidence: 99%

Clinical Experience in the Diagnosis and Treatment of Adult Acute Necrotizing Encephalopathy

Wang

Zhang

et al. 2022

Neuroimmunomodulation

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Purpose: We report two cases diagnosed as acute necrotizing encephalopathy (ANE) with acute onset and various clinical manifestations. Methods: The patients’ data were obtained from the medical records of the Binzhou Medical University Hospital in Binzhou, China. The clinical symptoms, laboratory examination, neuroimaging, treatment, and prognosis of the 2 patients were collected and analyzed. Results: We report 2 adult ANE patients with acute onset. The first symptom was fever, followed by symptoms and signs of damage to the central nervous system. The patients were infected with herpes simplex virus and influenza virus, respectively. The main manifestation on brain magnetic resonance imaging was a mixed-signal of a “three-layer structure” in the bilateral thalamus. The first patient died. Based on the experience of the diagnosis and treatment of the first patient, combined with a review of the literature, the second patient was immediately treated with glucocorticoid pulse therapy combined with gamma globulin injection. This patient’s condition was controlled, and the prognosis was good. Conclusions: This study describes the clinical symptoms, laboratory examination, neuroimaging evidence, and treatment experience of ANE in adults. We believe that the progress of the disease may be controlled, and the prognosis may be improved if glucocorticoid pulse therapy combined with gamma globulin injection is used as soon as possible.

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A case report of primary central nervous system lymphoma with intestinal obstruction as the initial symptom

Cited by 3 publications

References 14 publications

B-Cell Lymphoma Intramedullary Tumor: Case Report and Systematic Review

B-Cell Lymphoma Intramedullary Tumor: Case Report and Systematic Review

Surgical Intervention for Primary B-cell Lymphoma of the Spine

Clinical Experience in the Diagnosis and Treatment of Adult Acute Necrotizing Encephalopathy

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