The great mimicker at thoracolumbar spine: Non-Hodgkin’s lymphoma

Akgül, Turgut; Bilgin, Yücel; Karademir, Gökhan

doi:10.1016/j.ijscr.2017.08.034

Cited by 4 publications

(2 citation statements)

References 13 publications

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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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“…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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“…Lymphoma is colloquially referred to as the “great imitator/mimicker” of central nervous system disease [ 12 , 13 ], given its low incidence and presentation resembling other primary or metastatic spinal tumors. Here, we describe an interesting case of primary spinal lymphoma presenting as an epidural mass with extension through the neural foramina and co-existing pathologic vertebral body compression fracture.…”

Section: Introductionmentioning

confidence: 99%

Spinal Lymphoma Presenting as an Epidural and Retropleural Mass With Concomitant Pathologic Compression Fracture: A Case Report

Leclair¹,

Terai²,

Paro³

et al. 2022

Cureus

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Lymphoma has traditionally earned the nickname "the great mimicker". Its presentation as a primary spinal tumor is rare, and therefore seldom included in the differential diagnosis. However, its mimicking nature and diverse presentation make it very difficult to exclude entirely. Here, we present an elderly patient with histology-confirmed spinal lymphoma presenting as both an epidural mass with transforaminal extension into the retropleural space as well as vertebral body compression fracture, together leading to severe spinal stenosis and compressive myelopathy. Additional non-malignant compression fractures found in our patient allow for an interesting discussion on disease presentation and imaging-based diagnosis. We discuss our approach to diagnosis, surgical treatment, and post-operative medical care.

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