Abstract
IntroductionAlthough non-Hodgkin’s lymphoma is one of the most common and frequently fatal of the acquired immune deficiency syndrome-defining illnesses, survival has improved significantly since the introduction of antiretroviral therapy. Patients with spinal cord compression resulting from non-Hodgkin’s lymphoma present with clinically acute or rapidly progressive neurologic deficits. The purpose of this case report is to present a case of a patient seropositive for human immunodeficiency virus with spinal cord compression due to B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma.Case presentationA 40-year-old Asian man, who was seropositive for human immunodeficiency virus, presented with progressive neurological deficits. Magnetic resonance images of his thoracic spine showed an epidural mass from T2 to T4, resulting in severe cord compression. Emergent surgical decompression and biopsy were performed, followed by palliative radiation therapy. The pathologic findings showed that the specimen was compatible with B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma. Palliative radiation therapy was performed; however, leptomeningeal seeding and pulmonary embolism led to his death.ConclusionsWhen a patient infected with human immunodeficiency virus presents with a rapidly progressive spinal tumor accompanying paraplegia, non-Hodgkin’s lymphoma should be considered, and surgical decompression should be weighed with respect to the patient’s general condition and the subtype/prognosis of the lymphoma.
Highlights
Non-Hodgkin’s lymphoma is one of the most common and frequently fatal of the acquired immune deficiency syndrome-defining illnesses, survival has improved significantly since the introduction of antiretroviral therapy
When a patient infected with human immunodeficiency virus presents with a rapidly progressive spinal tumor accompanying paraplegia, non-Hodgkin’s lymphoma should be considered, and surgical decompression should be weighed with respect to the patient’s general condition and the subtype/prognosis of the lymphoma
We present a case of a patient with spinal cord compression caused by an acquired immune deficiency syndrome (AIDS)-related B-UCL with features intermediate between diffuse large B-cell lymphoma (DLBCL) and Burkitt lymphoma (BL)
Summary
Spine surgeons should consider the possibility of NHLassociated spinal cord compression in patients seropositive for HIV who present with rapidly progressive paraplegia, and treatment should take into account the patient’s condition in addition to the subtype and prognosis of the lymphoma. Consent Written informed consent was obtained from the patient’s next-of-kin for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests The authors declare that they have no competing interests. Authors’ contributions MUK and YCK analyzed and interpreted the patient data. JYS was a major contributor in writing the manuscript. All authors read and approved the final manuscript
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