Liao Jen-Chung, Fu Tsai-Sheng, Chen Wen-Jer, Jung Shih-Ming
Department of Orthopedics Surgery, Chang Gung Memorial Hospital, Taipei, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Chang Gung Med J. 2007 Sep-Oct;30(5):458-63.
Hodgkin's disease may involve the spine as a setting of the advanced disease. An initial manifestation of Hodgkin's disease in spine is extremely rare and the major involved sites usually are the thoracic or cervical spine. The mechanisms of pathogenesis for the formation of an epidural mass during Hodgkin's disease are hematogenous dissemination from nodal sites or local infiltration of lymphomatous tissue. We document here a case of a 16 year-old boy who suffered from incomplete voiding due to dumbbell-shaped retroperitoneal Hodgkin's disease with cauda equina compression. He was successfully managed using surgery and adjuvant chemotherapy. Although lymphadenomatous tissue responds well to radiotherapy and chemotherapy, the role of surgery in this case was to achieve immediate nerve tissue decompression and to obtain an adequate specimen for pathological diagnosis. Magnetic resonance imaging (MRI) is a non-invasive and helpful tool when detecting spinal and paraspinal lesions and we emphasize that spinal MRI should be performed without delay if there is persistent back pain or sciatica.
霍奇金淋巴瘤在疾病晚期可能累及脊柱。脊柱作为霍奇金淋巴瘤的首发表现极为罕见，主要受累部位通常是胸椎或颈椎。霍奇金淋巴瘤期间硬膜外肿块形成的发病机制是来自淋巴结部位的血行播散或淋巴瘤组织的局部浸润。我们在此记录一例16岁男孩的病例，该男孩因哑铃形腹膜后霍奇金淋巴瘤压迫马尾神经而出现排尿不完全。他通过手术和辅助化疗成功治愈。尽管淋巴瘤组织对放疗和化疗反应良好，但在该病例中手术的作用是立即实现神经组织减压并获取足够的标本进行病理诊断。磁共振成像（MRI）是检测脊柱和椎旁病变时一种无创且有用的工具，我们强调，如果存在持续性背痛或坐骨神经痛，应立即进行脊柱MRI检查。
