Department of Orthopaedic Surgery, Izumi Municipal Hospital, and Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Spine (Phila Pa 1976). 2009 Nov 15;34(24):E882-5. doi: 10.1097/BRS.0b013e3181b29de6.
A case report with a review of the literature.
To describe an unusual case of primary lymphoma of the cauda equina and provide a review of the literature of this condition.
Primary lymphoma of the cauda equina is extremely rare, and has been reported in 8 cases previously. This report is the first to describe a case of primary nasal type NK/T-cell lymphoma of the cauda equina.
We report the case of a 67-year-old man presenting the symptoms of cauda equina syndrome caused by primary lymphoma of the cauda equina.
After laminectomy and removal of the tumor, the patient recovered from the symptoms of cauda equina syndrome except for bladder and bowel dysfunction. Further investigations including immunohistochemical stains made a diagnosis of primary nasal type NK/T-cell lymphoma of the cauda equina, and the patient received radiotherapy to the lumbosacral area. Brain metastasis was detected 8 months after surgery, and the patient died 14 months after his initial clinical presentation despite additional treatments including whole-brain radiotherapy and oral chemotherapy.
Although primary lymphoma of the cauda equina is extremely rare, the prognosis of this condition is thought to be poor. Early definitive diagnosis with examination of the cerebrospinal fluid followed by combined treatment with radiotherapy and high-dose methotrexate should be considered.
病例报告并文献复习。
描述马尾原发性淋巴瘤的一个不常见病例，并对该疾病的文献进行回顾。
马尾原发性淋巴瘤极为罕见，此前仅报道过 8 例。本报告首次描述了一例马尾原发性鼻型 NK/T 细胞淋巴瘤。
我们报告了一例 67 岁男性，因马尾原发性淋巴瘤引起马尾综合征的症状。
行椎板切除术和肿瘤切除后，患者除了膀胱和肠道功能障碍外，马尾综合征的症状均得到缓解。进一步的免疫组化检查诊断为马尾原发性鼻型 NK/T 细胞淋巴瘤，患者接受了腰骶部放疗。术后 8 个月发现脑转移，尽管患者接受了全脑放疗和口服化疗等额外治疗，但在最初临床表现后 14 个月死亡。
尽管马尾原发性淋巴瘤极为罕见，但该疾病的预后较差。应考虑早期通过脑脊液检查明确诊断，然后采用放疗和大剂量甲氨蝶呤联合治疗。
