Primary bone lymphoma with multiple vertebral involvement

Abstract

A 20-year-old student presented with 2 months history of fever and night sweats, 15 days history of low backache, progressive weakness of both limbs of 7 days duration, and urinary retention for last 24 h. Examination revealed a sensory level at D 10 dermatome and grade two power in both the lower limbs with absent reflexes. Examination of spine revealed a knuckle at T8 level, which was tender on palpation. MRI spine showed erosion of D11-12 and L1 in vertebral bodies with destruction of left pedicles, transverse processes and lamina, and a prominent psoas abscess. Post gadolinium study revealed ring-enhancing lesions in the D11-12 and L1 vertebrae as well as the dural sac. Fine needle aspiration cytology (FNAC) and bone biopsy demonstrated a non-Hodgkin's lymphoma (NHL, large cell high-grade) of the spine (primary), which as per age is the youngest case of NHL ever reported in literature with multiple vertebral involvement.

Non-Hodgkin's Lymphoma Presenting as an Isolated Vertebral Collapse

“…PLB is defined as malignant lymphoid infiltrates within bone with or without arterial invasion or extension into contiguous soft tissue but without concurrent involvement of regional lymph nodes or distant viscera. 3 Spinal cord compression is commonly caused by extradural disease, either because of an isolated deposit within the spinal cord or by an extension from an adjacent nodal mass or bone involvement. Less commonly, NHL may arise subdurally or within the spinal cord.…”

Imaging of Malignant Primitive Tumors of the Spine

“…The treatment options of the primary bone lymphomas are surgical, chemotherapy, and radiotherapy [30]. Isolated spinal lymphoma responds very well to chemotherapy and radiotherapy.…”