P2-21-3 - Two Cases of Primary B Cell Lymphoma of Cauda Equina

Abstract

Introduction: The spinal cord is an extremely rare site for primary central nervous system lymphoma. Here, we present two cases of B cell lymphoma of cauda equina.Case1: A 80 year-old woman was admitted to our hospital with progressive pain and muscle weakness of both lower extremities. Magnetic resonance imaging (MRI) uncovered a tumor in cauda equina. A diagnosis of B cell lymphoma was made with cytological examination of cerebrospinal fluid. The patient received one cycle of high-dose methotrexate therapy, but it was not effective.Case2: A 62 year-old man was referred to our hospital because of a progressive pain and paralysis of lower extremities. MRI revealed a significant large tumor in the cauda equina. Diagnosis of diffuse large B cell lymphoma was made with biopsy of the tumor. The patient received three cycles of chemotherapy with high-dose methotrexate and high-dose cytarabine with 40 Gy of irradiation, leading to partial remission.Conclusion: We presented two cases of B cell lymphoma of cauda equina. Neither of the two cases achieved complete remission with high-dose methotrexate chemotherapy. Treatment of primary B cell lymphoma of spinal cord is very difficult because most cases are refractory to standard chemotherapy, including high-dose methotrexate. More effective therapeutic regimens with novel agents are urgently needed for treating primary B cell lymphoma of spinal cord.