EC Clinical and Medical Case Reports

Primary spinal epidural lymphoma is a very rare condition. In cases where spinal cord compression occurs, surgical decompression is required, followed by chemotherapy. A 46-year-old man presented with upper back pain accompanied by progressive sensory disturbances and weakness in the upper limb, particularly affecting the hand. Magnetic resonance imaging revealed an extradural, extramedullary lesion is identified at the level of T1, occupying the posterior epidural space with left foraminal extension. The patient underwent surgical decompression with tumor resection. Histopathological analysis identified the lesion as diffuse large B-cell lymphoma of the germinal center type. Chemotherapy was subsequently initiated by the hematology team, and the patient was referred to physical therapy due to mild paraparesis. Postoperative positron emission tomography showed no evidence of residual disease. Clinicians should consider primary spinal epidural lymphoma in patients presenting with back and leg pain. Early diagnosis and appropriate treatment are essential, as the prognosis is generally favorable when managed promptly.

Keywords: Thoracic Spine; Primary Spinal Epidural Lymphoma; Foraminal Extension; Chemotherapy

1. Cugati G., et al. “Primary spinal epidural lymphomas”. Journal of Craniovertebral Junction and Spine 1 (2011): 3-11.
2. Shu Y., et al. “Primary spinal epidural diffuse large B-cell lymphoma with paraplegia as the first manifestation: a case report”. OncoTargets and Therapy 12 (2019): 6497-6501.
3. Moussaly E., et al. “Primary non-Hodgkin’s lymphoma of the spine: A case report and literature review”. World Journal of Oncology 5 (2015): 459-463.
4. Zheng JS., et al. “Isolated primary nonHodgkin’s lymphoma of the thoracic spine: a case report with a review of the literature”. Journal of International Medical Research 4 (2010): 1553-1560.
5. Córdoba-Mosqueda ME., et al. “Primary spinal epidural lymphoma as a cause of spontaneous spinal anterior syndrome: A case report and literature review”. Journal of Neurological Surgery Reports 1 (2017): e1-e4.
6. Di Marco A., et al. “Non-Hodgkin lymphomas presenting with spinal epidural involvement”. Acta Oncologica 4 (1989): 485-488.
7. Vanneuville B., et al. “Non-Hodgkin’s lymphoma presenting with spinal involvement”. Annals of the Rheumatic Diseases 1 (2000): 12-14.
8. Mally R., et al. “Primary lumbo-sacral spinal epidural non Hodgkin’s Lymphoma: A case report and review of literature”. Asian Spine Journal 3 (2011): 192-195.
9. Jagtap SA., et al. “Primary spinal epidural diffuse large B-cell lymphoma”. Neurology India 5 (2013): 532-534.
10. Tsukada T., et al. “Primary epidural non-Hodgkin's lymphoma in clinical stage IEA presenting with paraplegia and showing complete recovery after combination therapy”. Internal Medicine4 (1992): 513-515.