TITLE:
A Patient with Malignant Spinal Epidural Lymphoma with Initial Rapidly Aggravating Paraplegia
AUTHORS:
Taihei Go, Yasuaki Iida, Hideyuki Aoki, Shintaro Tsuge, Keiji Hasegawa, Yuichiro Yokoyama, Akihito Wada, Yuri Akishima-Fukasawa, Hiroshi Takahashi
KEYWORDS:
Malignant Lymphoma, Epidural Mass, Paraplegia, Thoracic Spine
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.7 No.3,
March
31,
2017
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.