Primary Dural Spinal Lymphoma Presentation of a Rare Spinal Tumor Case.

Dilber Ayçiçek Çeçen,Hikmet Turan Süslü,Selçuk Özdoğan,Nagehan Özdemir Barışık,Necati Tatarlı

doi:10.1155/2015/639253

Dilber Ayçiçek Çeçen, Hikmet Turan Süslü + Show 3 more

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https://doi.org/10.1155/2015/639253

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Abstract

Background. Primary spinal dural lymphomas (PSDL) are tumors with characteristic histopathology of a lymphoma, which are completely in the spinal epidural space without any other systemic involvement. Extranodal primary lymphoma involving nervous system prefers thalamus/basal ganglia, periventricular region, cerebellum, eyes, meninges/dura, and cranial nerves or spinal cord. Rare spinal localization with acute spinal cord compression is worth attention. Case Presentation. A 48-year-old male presented with a several-month-long history of upper back pain. Lately, he had numbness and weakness at both lower extremities and was unable to walk for one week. A spinal MRI showed a thoracic lesion with cord compression at T2–T4 levels. The patient underwent surgical decompression, with his final histopathology showing diffuse large B-cell lymphoma. Systemic work-up was negative for nodal disease. Following surgery, he received radiotherapy combined with chemotherapy. He experienced a good outcome after four years. Conclusion. The upper thoracic cord is a rare location for primary spinal lesions/metastases, both of which prefer the lower thoracic and upper lumbar regions. In cases of progressive paraparesis, there should be immediate surgical intervention in the case of denovo disease, followed by combined radiotherapy and chemotherapy procedures.

Highlights

Spinal dural involvement in lymphoma is an entity diagnosed with secondary progression of systemic or other organs’ disease which is metastatic primary lymphoma dissemination [1, 2]
Few case reports with other histological subtypes have been described including nonHodgkin, Hodgkin, and marginal zone lymphoma types [3,4,5,6, 9]
Our study demonstrated no associated substance use or systemic diseases that would affect immune competence [5]

Summary

Background

Primary spinal dural lymphomas (PSDL) are tumors with characteristic histopathology of a lymphoma, which are completely in the spinal epidural space without any other systemic involvement. Extranodal primary lymphoma involving nervous system prefers thalamus/basal ganglia, periventricular region, cerebellum, eyes, meninges/dura, and cranial nerves or spinal cord. A 48-year-old male presented with a several-month-long history of upper back pain. He had numbness and weakness at both lower extremities and was unable to walk for one week. Systemic work-up was negative for nodal disease Following surgery, he received radiotherapy combined with chemotherapy. He experienced a good outcome after four years. The upper thoracic cord is a rare location for primary spinal lesions/metastases, both of which prefer the lower thoracic and upper lumbar regions. In cases of progressive paraparesis, there should be immediate surgical intervention in the case of denovo disease, followed by combined radiotherapy and chemotherapy procedures

Introduction

Case Presentation

Findings

Discussion