A Rare Case of Malignant Lymphoma Occurred at Spinal Epidural Space: A Case Report

Cho, Hyun Jun; Lee, Jang Bo; Hur, Junseok W.; Jin, Sung Won; Cho, Tai Hyoung; Park, Jung Youl

doi:10.14245/kjs.2015.12.3.177

Cited by 17 publications

(18 citation statements)

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“…The most common invasion sites of spinal tumors include the midthoracic (69%), lumbar (27%), and cervical spine (4%). [ 3 ] PCNSL, defined as NHL that can invade not only the brain but also the leptomeninges, eyes, and spinal cord, is extremely rare. [ 4 ] Spinal tumors can lead to spinal cord compression and result in a series of unspecific symptoms, such as IO in this case.…”

Section: Discussionmentioning

confidence: 99%

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

Li¹,

Jiao³

et al. 2018

Medicine

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Rationale:Primary central nervous system lymphoma (PCNSL) with initial manifestations of constipation and intestinal obstruction (IO) is rare.Patient concerns:A 50-year-old Chinese male patient was admitted to the gastroenterology department due to constipation and abdominal distention for 8 days. He had experienced intermittent back pain for 3 years prior to admission. Based on abdominal radiography, he was initially diagnosed with IO and treated with meal restriction and enemas. However, his symptoms worsened, and progressive lower limb weakness was observed.Diagnoses:A colonoscopy was inconclusive due to the IO. Computed tomography and magnetic resonance imaging revealed space-occupying lesions near centrums 9–11 of the thoracic vertebrae. The patient underwent spinal decompression surgery, and pathologic examination led to a diagnosis of PCNSL (diffuse large B cell lymphoma).Outcomes:The symptoms of the IO improved postoperatively, and the patient partially recovered his lower limb muscle strength. He returned to his homeland for chemotherapy.Lessons:IO can be an initial, unspecific symptom of spinal cord compression in patients with PCNSL.

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Section: Discussionmentioning

confidence: 99%

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

Li¹,

Jiao³

et al. 2018

Medicine

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“…Extranodal non-Hodgkin's lymphoma (NHL) accounts for 24 to 48% of all NHL. 2 It is reported that lymphoma limited to the spinal epidural space participates in up to 3.3% of all lymphomas, 9% of epidural spinal tumors, 3 and 0.9% of all extranodal NHL. Male preponderance of 69% and a male/female ratio of 2:7 were observed.…”

Section: Discussionmentioning

confidence: 99%

Primary Spinal Epidural Lymphoma As a Cause of Spontaneous Spinal Anterior Syndrome: A Case Report and Literature Review

et al. 2017

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Background Primary spinal epidural lymphoma (PSEL) is one of the rarest categories of tumors. Spinal cord compression is an uncommon primary manifestation and requires to be treated with surgery for the purpose of diagnosis and decompression. Case Presentation A 45-year-old man presented with a new onset thoracic pain and progress to an anterior spinal syndrome with hypoesthesia and loss of thermalgesia. Magnetic resonance image showed a paravertebral mass that produces medullary compression at T3. The patient was taken up to surgery, where the pathology examination showed a diffuse large B-cell lymphoma. Conclusions PSEL is a pathological entity, which must be considered on a middle-aged man who began with radicular compression, and the treatment of choice is decompression and biopsy. The specific management has not been established yet, but the literature suggests chemotherapy and radiotherapy; however, the outcome is unclear.

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“…2 It is reported that lymphoma limited to the spinal epidural space participates in up to 3.3% of all lymphomas, 9% of epidural spinal tumors, 3 and 0.9% of all extranodal NHL. Male preponderance of 69% and a male/female ratio of 2:7 were observed.…”

Section: Discussionmentioning

confidence: 99%

“…5 The proper management of patients with primary epidural NHL is not yet certain, 2 and several studies suggest that patients with features of spinal cord compression require to be treated with surgery for the purpose of both tissue diagnosis and decompression. 3 Generally, acute paresis and/or loss of bladder/bowel control require emergency decompression of the spinal cord. The surgical approach depends mainly on the location of the tumor, the degree of spinal cord compression, spinal instability, and the patient's general condition.…”

Section: Discussionmentioning

confidence: 99%

“…9 The researchers suggest that the combination therapy of surgical and radiotherapy and/or chemotherapy should be done. 3 Radiation therapy doses of at least 25 Gy and chemotherapeutic agents such as cyclophosphamide, vincristine, and prednisone have been recommended. 5 The prognosis for functional recovery in patients with spinal cord compression due to epidural NHL is relatively better than that of patients with metastatic carcinoma.…”

Section: Discussionmentioning

confidence: 99%

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2017

J Neurol Surg Rep

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IntroductionPrimary spinal cord tumors are one of the rarest categories of tumors, representing approximately 4 to 16% of all tumors arising from the central nervous system (CNS). 1 An epidural location for lymphoma is observed in 0.1 to 6.5% of the cases.We describe the diagnostic and management of a 45-yearold man who presented an anterior spinal syndrome secondary to an epidural lesion, which had a histological confirmation of a diffuse large B-cell lymphoma (DLBCL). Case PresentationA 45-year-old man presented with a new onset of highintensity thoracic pain limiting his movements; a month later he was accompanied by decrease in the strength of the left pelvic limb. After 2 months, he started with weakness of both lower limbs and impaired urinary sphincter control.The neurologic examination demonstrated a minor motor impairment of lower limbs and reflexes were hyperactive. He presented a sensory level of hypoesthesia and loss of thermalgesia at T5. Anal sphincter tone was without damage, negative Hoffman, Trömner and Babinski's sign.Magnetic resonance images showed a paravertebral mass hypointense on T1 and T2 with homogeneous enhancement, which produced medullar compression at T3 (►Figs. 1 and 2).The patient was taken into surgery, where we performed a neural decompression by posterior way and biopsy of the extradural spinal lesion. Intraoperatively, we found a fibrotic, gray-colored, vascularized lesion on the right side above the T3-T4 level (►Fig. 3). Keywords► spinal epidural lymphoma ► epidural ► spinal compression AbstractBackground Primary spinal epidural lymphoma (PSEL) is one of the rarest categories of tumors. Spinal cord compression is an uncommon primary manifestation and requires to be treated with surgery for the purpose of diagnosis and decompression. Case Presentation A 45-year-old man presented with a new onset thoracic pain and progress to an anterior spinal syndrome with hypoesthesia and loss of thermalgesia. Magnetic resonance image showed a paravertebral mass that produces medullary compression at T3. The patient was taken up to surgery, where the pathology examination showed a diffuse large B-cell lymphoma. Conclusions PSEL is a pathological entity, which must be considered on a middle-aged man who began with radicular compression, and the treatment of choice is decompression and biopsy. The specific management has not been established yet, but the literature suggests chemotherapy and radiotherapy; however, the outcome is unclear.

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A Rare Case of Malignant Lymphoma Occurred at Spinal Epidural Space: A Case Report

Cited by 17 publications

References 17 publications

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

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

Primary Spinal Epidural Lymphoma As a Cause of Spontaneous Spinal Anterior Syndrome: A Case Report and Literature Review

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