Primary intramedullary lymphoma of the spinal cord mimicking cervical spondylotic myelopathy.

Caruso, Paul; Patel, Monaliben; Joseph, Jacob R.; Rachlin, Jacob

doi:10.2214/ajr.171.2.9694495

Cited by 26 publications

(11 citation statements)

References 3 publications

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“…The MRI appearances in this case resemble those in previously published cases [3,14,15,16] with an intramedullary, contrast-enhancing lesion giving markedly high signal on T2-weighted images. They are also similar to those of cerebral PCNSL, with Fig.…”

Section: Discussionsupporting

confidence: 81%

“…4), probably due to incomplete closure of the dura mater. Extraneural disease has been reported in 3 of 14 patients with primary spinal cord lymphoma, including this case [16,21]. This is slightly higher than the 6-10% of patients with cerebral PCNSL who develop extraneural disease in the course of the disease [22].…”

Section: Discussionmentioning

confidence: 98%

“…In most cases, craniospinal irradiation appears to be more effective than local treatment in terms of temporary tumour control, but only rarely leads to long-term survival or cure. Thus, as in cerebral PCNSL, combined chemo-and radiotherapy [3,26,27] or chemotherapy alone [16] appear attractive. Although combined radio-and chemotherapy was unsuccessful in our present case, previous use of chemotherapy with or without radiation achieved survival times of from 8 to more than 60 months.…”

Section: Discussionmentioning

confidence: 99%

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Primary CNS lymphoma in the spinal cord: clinical manifestations may precede MRI delectability

2002

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We report a 36-year-old woman whose first MRI after developing symptoms of cervical nerve root irritation was normal. Eight months later, after progression to tetraparesis and demonstration of an extensive contrast-enhancing intramedullary lesion giving high signal on T2-weighted images, the diagnosis of lymphoblastic non-Hodgkin's lymphoma was made by biopsy. The lesion responded for a short time to corticosteroid medication, but later rapidly extended to the epidural soft tissues, probably due to a cerebrospinal fluid fistula. Despite radio-and chemotherapy, the patient survived only 7 months from histological diagnosis and 15 months from the onset of symptoms.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Primary CNS lymphoma in the spinal cord: clinical manifestations may precede MRI delectability

2002

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“…2 Other studies focusing on PISCL were mostly case reports with the majority of patients being female but with various age distributions. 1,[3][4][5]7,8,10,[12][13][14][15][16][17][18][19] The variable demographic patterns of PISCL patients likely reflect the rarity of PISCL and therefore the limited number of studies conducted on this disease. However, when compared with literature in the context of primary CNS lymphomas, our patient demographics are consistent with existing reports.…”

Section: Discussionmentioning

confidence: 99%

Primary intramedullary spinal cord lymphoma: a population-based study

Yang

Garzón-Muvdi

Braileanu

et al. 2016

NEUONC

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Background. Primary intramedullary spinal cord lymphoma (PISCL) is a rare diagnosis with poorly understood disease progression. Clarification of the factors associated with survival in PISCL patients is warranted. Methods. We conducted a population-based cohort study utilizing prospectively collected data from the Surveillance, Epidemiology, and End Results (SEER) database. Patients with histological diagnosis of primary lymphoma in spinal cord (C72.0) from 1973 to 2012 in the SEER database were included. Multivariable survival analysis between patient, lesion characteristics, and PISCL-related death was performed to adjust for confounding factors. Results. We included 346 PISCL patients in our study. Average age was 56.5 ± 17.8 years, with 62.7% being male. Racial distribution of these patients was white (87.6%), black (8.0%), and other (4.3%). More than half (55.8%) of patients were married. The most prevalent histology of PISCL was diffuse B-cell (46.2%), and the majority (55.2%) were low stage (Ann Arbor stage I/II). Most patients (67.9%) received radiation therapy. Average survival interval of patients with PISCL-related death (n=135, 39.0%) was 27.8 months. General cumulative survival probability at 1 year, 2 years, and 5 years was 73.8%, 67.9%, and 63.1%, respectively. Multivariable accelerated failure time (AFT) regression showed follicular lymphoma (HR:0.25, P=.008) and more recent diagnosis (HR:0.96, P<.001) was positively associated with PISCL-related survival. Conversely, nonwhite race (HR:1.69, P=.046), older age (HR:1.02, P<.001), unmarried status (HR:2.14, P<.001), and higher stage (HR:1.54, P=.022) were negatively associated with survival. Conclusions. Age, race, marital status, tumor histology, tumor stage, and year of diagnosis were associated with survival of PISCL. While most PISCL-related deaths occur within a 1-year period, subsequent slow progression was observed after the first year of survival.

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“…24) Only 21 cases of primary spinal intramedullary lymphoma have been reported including our case (Table 1). [2][3][4][5][8][9][10]12,13,[15][16][17][18][19][20][21]23,[25][26][27] Review of all cases of primary spinal malignant lymphoma revealed that the patients were aged 24-77 years (mean 51.4 years), with 10 males and 11 females. The location was cervical in 8 cases, thoracic in 2, lumbar and conus in 3, cauda equina in 2, and multiple in 6.…”

Section: Discussionmentioning

confidence: 99%

Primary Cauda Equina Lymphoma Treated With High-Dose Methotrexate

Iwasaki

Hida

Yano

et al. 2012

Neurol. Med. Chir.(Tokyo)

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Fig. 1 Sagittal T 2 -weighted magnetic resonance image (A), and sagittal (B) and axial (C: T12, D: L1) T 1 -weighted images with gadolinium-diethylenetriaminepenta-acetic acid showing compression fracture, intramedullary hyperintensity, and enhancement at the L1 level. 679 CASE REPORT AbstractA 69-year-old man presented with a very rare case of primary central nervous system lymphoma originating in the cauda equina manifesting as progressive paraparesis. The patient underwent a biopsy, and was treated with intravenous high-dose (3.5 g/m 2 ) methotrexate chemotherapy and local irradiation. Histological study revealed large B cell type lymphoma. Follow-up magnetic resonance imaging showed complete remission of the lesion, but the patient died of pneumonia at 18 months after the initial onset without tumor recurrence, so the efficacy of this strategy remains unknown.

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Primary intramedullary lymphoma of the spinal cord mimicking cervical spondylotic myelopathy.

Cited by 26 publications

References 3 publications

Primary CNS lymphoma in the spinal cord: clinical manifestations may precede MRI delectability

Primary CNS lymphoma in the spinal cord: clinical manifestations may precede MRI delectability

Primary intramedullary spinal cord lymphoma: a population-based study

Primary Cauda Equina Lymphoma Treated With High-Dose Methotrexate

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