Primary Epidural non-Hodgkin's Lymphoma in Clinical Stage IEA Presenting with Paraplegia and Showing Complete Recovery after Combination Therapy.

Tsukada, Tetsuya; Ohno, Toshiyuki; Tsuji, Kota; Kita, K; Kobayashi, Toshimitsu; Deguchi, Katsumi; Shirakawa, S

doi:10.2169/internalmedicine.31.513

Cited by 22 publications

(32 citation statements)

References 8 publications

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“…Other cases of B-cell lymphoma of the epidural space resulted in functional community ambulation by 10 months and remission of at least 2 years in a patient with laminectomy, decompression, and biopsy followed by field radiation therapy and modified CHOP (cyclophosphamide, Adriamycin, vincristine, and prednisolone) chemotherapy (11). This is consistent with our 2 cases, where community level ambulation without an assistive device was achieved by both patients.…”

Section: Discussionsupporting

confidence: 89%

Spinal Cord Injury Caused by Epidural B-Cell Lymphoma: Report of Two Cases

Chiodo

2007

The Journal of Spinal Cord Medicine

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Background/Objective: Spinal cord injury (SCI) caused by cancer is increasing in incidence as the mean age of our patient population increases. Understanding the prognosis and functional outcome requires knowledge of diseases of the spinal column. This paper presents the unusual presentation of epidural B-cell lymphoma.Methods: Case reports.Results: Two patients presented with an unusual cause of SCI, namely B-cell lymphoma. Both patients presented with sensory deficits greater than motor deficits and gait disorder. Both achieved functional independence at the community ambulation level and tumor remission with chemotherapy and radiation therapy.Conclusions: B-cell epidural tumors are an uncommon cause of SCI. Functional outcome can be quite good, as can tumor outcome. Residual sensory deficits greater than motor deficits are not uncommon. INTRODUCTIONWith safety initiatives to prevent catastrophic neurologic injuries and with our aging society, the absolute and relative incidence of nontraumatic spinal cord injury (SCI) is on the rise. In the older population, unique causes of SCI directly related to age are seen, such as cervical stenosis from degenerative and rheumatologic causes, ischemia caused by abdominal aortic aneurysms, and cancer. Tumor-related SCI represents 25% of nontraumatic SCIs and 8% of all SCI cases (1). In all cancer cases, understanding the tumor type for correct identification allows for treatment planning and prognosis setting. This is critical in understanding the role of rehabilitation and setting reasonable functional goals for the individual patient. Neurologic status, overall health, extent of disease (spinal and extraspinal), and primary pathology influence proper treatment selection (2). A 1-year survival after rehabilitation for patients with metastatic spine

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Section: Discussionsupporting

confidence: 89%

Spinal Cord Injury Caused by Epidural B-Cell Lymphoma: Report of Two Cases

Chiodo

2007

The Journal of Spinal Cord Medicine

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“…Extranodal non-Hodgkin's lymphoma (NHL) comprises 24% to 48% of all NHL ( 1 ), while PSEL accounts for 0.9% of all extranodal NHL ( 2,3 ). Th e largest series to date was reported by Monnard et al ( 4 ), who studied 52 patients treated in nine institutions of the Rare Cancer Network between 1982 and 2002.…”

Section: Discussionmentioning

confidence: 99%

Primary Spinal Epidural B-Lymphoblastic Lymphoma

Nambiar

Nair

Prabhakaran

et al. 2017

Baylor University Medical Center Proceedings

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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 prognosis for functional recovery in patients with spinal cord compression due to epidural NHL is relatively better than that of patients with metastatic carcinoma. 2 It is reported in many series that nonambulant patients with spinal cord compression have only a 10 to 30% chance of becoming ambulant after therapy; however, earlier diagnosis and treatment are associated with improved functional outcome. 8 Our patient presents an excellent evolution, and he has just begin with his chemotherapy and radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Untitled

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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Primary Epidural non-Hodgkin's Lymphoma in Clinical Stage IEA Presenting with Paraplegia and Showing Complete Recovery after Combination Therapy.

Cited by 22 publications

References 8 publications

Spinal Cord Injury Caused by Epidural B-Cell Lymphoma: Report of Two Cases

Spinal Cord Injury Caused by Epidural B-Cell Lymphoma: Report of Two Cases

Primary Spinal Epidural B-Lymphoblastic Lymphoma

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