Primary Cauda Equina T-Cell Lymphoblastic Lymphoma

Jorrit De Vries*, Marinus D. Oterdoom, Wilfred F. Den Dunnen, Roelien H. Enting, Reina W. Kloet, Wilfried W. Roeloffzen, Hanne-Rinck R. Jeltema

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

BACKGROUND: T-cell lymphoblastic lymphoma (T-LBL) is a rare and aggressive form of non-Hodgkin lymphoma. This report describes, to our knowledge, the first adult case of a primary cauda equina T-LBL. Treatment consists of multiagent chemotherapy, and surgical removal of T-LBL does not improve outcome. We discuss the workup of patients with an intradural spinal mass, together with a review of the literature on primary spinal lymphoma of the cauda equina.

CASE DESCRIPTION: A 54-year-old woman with Crohn's disease, for which she was taking immunosuppressive medication, presented with progressive back pain radiating to both legs and deteriorating neurologic deficits caused by an intradural, contrast-enhancing lesion in the L1-5 region. During acute surgery, the tumor was partially resected. Immunohistochemical phenotyping revealed a T-LBL. No other lymphoma localizations were found after subsequent staging. Despite extensive treatment, the patient died of disseminated disease throughout the central nervous system, 6 weeks after the diagnosis.

CONCLUSIONS: Pain and progressive neurologic complaints can be symptoms of a (malignant) intradural spinal tumor. Intradural lymphoma must be considered as a differential diagnosis by clinicians because it can mimic neoplasms that often require urgent surgery. The histopathologic diagnosis should preferably be obtained by way of cerebrospinal fluid analysis or tumor biopsy because tumor resection has no beneficial effect on the oncologic outcome.

Original languageEnglish
Pages (from-to)227-232
Number of pages6
JournalWorld neurosurgery
Volume142
DOIs
Publication statusPublished - Oct-2020

Keywords

  • Cauda equina
  • Intradural
  • Non-Hodgkin lymphoma
  • T-cell lymphoblastic lymphoma
  • NERVOUS-SYSTEM LYMPHOMA
  • CNS LYMPHOMA

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