Ibarra B, Romero F J, Torrents C, Rovira M
Servicio de Neurorradiología, Hospital General Vall d'Hebron, Barcelona.
Neurologia. 1990 Feb;5(2):48-51.
We have gone through the computerized tomographies (CT) of four cases of spinal epidural lymphomas (SEL) studied in our department. Paraparesis with a sensitive level was the beginning of the disease three times; sciatic pain with recurrent fever once. A myelography followed by CT was done in the three cases of paraparesis while a non-contrast CT and a contrast-enhanced study was done in the case of sciatic pain. An homogeneous intraspinal mass stretching at least along one vertebral segment was the most usual finding. This mass spread into paraspinal tissue effacing fat lines. The mass was hyperdense in relation to dural sack and was limited to intraspinal space in one occasion. We have revised bibliography about osseous lesions in SEL and have found out disagreement on it. We have found them only once in our study. Intrathecal contrast was useless in determining tumour nature but useful in delimiting intraspinal extent. We have searched for tomographic features in order to establish differential diagnosis with other spinal epidural diseases. We did not find any SEL-exclusive features but we found that an homogeneous intra-extraspinal mass, extended at least along one vertebral segment and either producing or not producing osseous lesions can make us think of the presence of spinal epidural lymphoma.
我们查看了本部门研究的4例脊柱硬膜外淋巴瘤（SEL）的计算机断层扫描（CT）。3例患者以伴有感觉平面的双下肢轻瘫为疾病起始表现；1例以坐骨神经痛伴反复发热为起始表现。3例双下肢轻瘫患者先进行了脊髓造影，随后进行CT检查，而坐骨神经痛患者进行了平扫CT和增强扫描。最常见的表现是一个均匀的椎管内肿块，至少延伸一个椎体节段。该肿块蔓延至椎旁组织，使脂肪线消失。相对于硬脊膜囊，该肿块呈高密度，有1例局限于椎管内。我们查阅了有关SEL骨病变的文献，发现对此存在分歧。在我们的研究中仅发现过一次。鞘内造影剂对确定肿瘤性质无用，但对界定椎管内范围有用。我们寻找了断层扫描特征以建立与其他脊柱硬膜外疾病的鉴别诊断。我们未发现任何SEL特有的特征，但发现一个均匀的椎管内外肿块，至少延伸一个椎体节段，无论是否产生骨病变，都可使我们考虑存在脊柱硬膜外淋巴瘤。
