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[马尾综合征的罕见病因:原发性硬膜外淋巴瘤]

[A rare cause of cauda equina syndrome: primary epidural lymphoma].

作者信息

Bachmeyer C, Kazerouni F, Langman B, Daumas L, Hessler P

机构信息

Département de médecine interne, Centre Hospitalier Laennec, Bd Laennec, BP 72, 60109 Creil Cedex.

出版信息

Presse Med. 2005 Sep 10;34(15):1082-3. doi: 10.1016/s0755-4982(05)84122-3.

Abstract

INTRODUCTION

Primary epidural lymphoma is generally manifested by isolated epidural involvement. On rare occasions it can lead to cauda equina syndrome.

CASE

A 56-year-old man was hospitalized for lumbago, weakness in the legs and sphincter problems. A dorsolumbar MRI revealed that the anterior and posterior peridural space from D11 to L3 was filled by a mass compressing the marrow and compacting the roots. The L2 to L4 laminectomy revealed an extradural tissue leading to the diagnosis of large B-cell lymphoma. Metastatic workup demonstrated unremarkable findings.

DISCUSSION

Primary epidural lymphoma accounts for less than 10% of epidural tumours and less than 1% of non-Hodgkin lymphomas. Its clinical manifestations are related to the tumoral process or involvement of medullar vessels. It can be, but rarely is, manifested by cauda equina syndrome. Diagnosis is based on histological analysis of tissue taken during the decompression laminectomy. Prognosis is relatively good.

摘要

引言

原发性硬膜外淋巴瘤通常表现为孤立的硬膜外受累。极少数情况下可导致马尾综合征。

病例

一名56岁男性因腰痛、腿部无力和括约肌问题入院。胸腰椎MRI显示,从D11到L3的硬膜外前后间隙被一个肿块填满,该肿块压迫骨髓并挤压神经根。L2至L4椎板切除术显示硬膜外组织,诊断为大B细胞淋巴瘤。转移检查结果无异常。

讨论

原发性硬膜外淋巴瘤占硬膜外肿瘤的比例不到10%,占非霍奇金淋巴瘤的比例不到1%。其临床表现与肿瘤进展或髓内血管受累有关。它可以表现为马尾综合征,但很少见。诊断基于减压椎板切除术中获取的组织的组织学分析。预后相对较好。

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