A Patient with Malignant Spinal Epidural Lymphoma with Initial Rapidly Aggravating Paraplegia

Taihei Go,Akihito Wada,Keiji Hasegawa,Yuri Akishima-Fukasawa,Hideyuki Aoki,Hiroshi Takahashi,Yasuaki Iida,Shintaro Tsuge,Yuichiro Yokoyama

doi:10.4236/ojo.2017.73011

Abstract

We report the case of a 51-year-old female with rapid neurological deterioration as an initial presentation of non-Hodgkin’s lymphoma. Paraplegia occurred suddenly after a 4-day history of weakness and numbness of the lower extremity. MRI revealed a dorsal epidural mass from T10 to T11 that compressed the spinal cord. There was neither bone destruction nor a paravertebral mass. Emergency decompressive laminectomy and tumor resection were performed. Histological analysis of the surgical specimen indicated diffuse large B cell lymphoma. The clinical stage was IV on CT and complete remission was achieved by subsequent chemotherapy. Spinal cord compression occurs in the course of non-Hodgkin’s lymphoma in 0.1% - 6.5% of cases, but this situation usually develops in the late phase with bone destruction and/or a paravertebral mass. Cord compression and especially the severe symptoms such as paraplegia are rare as the initial presentation of lymphoma.

Highlights

We report the case of a 51-year-old female with rapid neurological deterioration as an initial presentation of non-Hodgkin’s lymphoma
Epidural tumors account for about 9% of malignant spinal epidural lymphomas, and spinal epidural lesions are observed during the course in 0.1% - 6.5% of all malignant lymphomas [1]
Many cases develop as spinal epidural metastasis of a malignant lymphoma, and cases presenting with initial spinal epidural lesions are rare

Summary

Introduction

Epidural tumors account for about 9% of malignant spinal epidural lymphomas, and spinal epidural lesions are observed during the course in 0.1% - 6.5% of all malignant lymphomas [1]. Many cases develop as spinal epidural metastasis of a malignant lymphoma, and cases presenting with initial spinal epidural lesions are rare. Symptoms of malignant spinal epidural lymphoma-induced spinal cord compression progress within days to weeks, which make early definite diagnosis and treatment important. A few studies have suggested that ma-. We encountered a patient with malignant spinal epidural lymphoma that initially presented as rapidly aggravating paraplegia, and we investigated the MRI findings. We report the case with a literature review

Case Report

Discussion

Findings

Conclusion