Smith Zachary A, Sedrak Mark F, Khoo Larry T
Department of Neurosurgery, Ronald Reagan-UCLA Medical Center; Los Angeles, CA 90095, USA.
J Med Case Rep. 2010 Feb 2;4:35. doi: 10.1186/1752-1947-4-35.
Non-Hodgkin lymphoma primarily originating from the bone is exceedingly rare. To our knowledge, this is the first report of primary bone lymphoma presenting with progressive cord compression from an origin in the cervical spine. Herein, we discuss the unusual location in this case, the presenting symptoms, and the management of this disease.
We report on a 23-year-old Caucasian-American man who presented with two months of night sweats, fatigue, parasthesias, and progressive weakness that had progressed to near quadriplegia. Magnetic resonance (MR) imaging demonstrated significant cord compression seen primarily at C7. Surgical management, with corpectomy and dorsal segmental fusion, in combination with adjuvant chemotherapy and radiation therapy, halted the progression of the primary disease and preserved neurological function. Histological analysis demonstrated an aggressive anaplastic large cell lymphoma.
Isolated primary bony lymphoma of the spine is exceedingly rare. As in our case, the initial symptoms may be the result of progressive cervical cord compression. Anterior corpectomy with posterolateral decompression and fusion succeeded in preventing progressive neurologic decline and maintaining quality of life. The reader should be aware of the unique presentation of this disease and that surgical management is a successful treatment strategy.
主要起源于骨骼的非霍奇金淋巴瘤极为罕见。据我们所知，这是首例起源于颈椎并导致进行性脊髓压迫的原发性骨淋巴瘤报告。在此，我们讨论该病例的不寻常发病部位、临床表现及本病的治疗方法。
我们报告一名23岁的美籍高加索男性，出现盗汗、疲劳、感觉异常以及进行性肌无力达两个月，病情进展至接近四肢瘫痪。磁共振成像（MR）显示主要在C7水平存在明显的脊髓压迫。通过椎体切除和后路节段融合的手术治疗，联合辅助化疗和放疗，阻止了原发性疾病的进展并保留了神经功能。组织学分析显示为侵袭性间变性大细胞淋巴瘤。
孤立性脊柱原发性骨淋巴瘤极为罕见。如我们的病例所示，初始症状可能是颈椎进行性脊髓压迫的结果。前路椎体切除联合后外侧减压及融合术成功地预防了神经功能的进行性衰退并维持了生活质量。读者应了解本病的独特表现，且手术治疗是一种成功的治疗策略。
