Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of primary intramedullary spinal cord lymphoma diagnosed by spinal cord biopsy of long spinal cord lesions showing persistent gadolinium contrast enhancement

Atsushi Okano, M.D.1), Masahiro Kanai, M.D.1), Takanobu Kita, M.D.1),Yoshiyuki Nakai, M.D.1), Hiroaki Okada, M.D.1) and Keiji Yamaguchi, M.D., Ph.D.1)

1) Department of Neurology, Ichinomiya-Nishi Hospital

An 82-year-old man presented with subacute bilateral lower limb paralysis, deep sensory disturbance, and vesicorectal disturbance. MRI of the spinal cord revealed a large gray matter-dominant lesion extending from the medulla oblongata to the lower thoracic spinal cord. The patient was treated with steroid-pulse therapy for myelitis, but without symptomatic improvement. A spinal cord biopsy was performed for treatment-resistant myelopathy, and histopathology revealed a diffuse large B-cell lymphoma, that was diagnosed as a primary intramedullary spinal cord lymphoma because systemic examination didn't show any other findings suggestive of malignant lymphoma. A spinal cord biopsy is necessary for the definitive diagnosis of this disease, but in the case of poor response to treatment and a progressive course, intramedullary malignant lymphoma should be considered if there is a persistent elevation of CSF IL-10 or a prolonged contrast effect.
Full Text of this Article in Japanese PDF (2886K)

(CLINICA NEUROL, 61: 856|861, 2021)
key words: myelopathy, primary intramedullary spinal cord lymphoma, diffuse large B-cell lymphoma, interleukin 10, spinal cord biopsy

(Received: 12-Jun-21)