Kim You-Sub, Lee Jung-Kil, Choi Ki-Young, Jang Jae-Won
Department of Neurosurgery, Chonnam National University Medical School & Research Institute of Medical Sciences, Gwangju, Korea.
Korean J Spine. 2015 Sep;12(3):221-4. doi: 10.14245/kjs.2015.12.3.221. Epub 2015 Sep 30.
Non-Hodgkin's lymphoma (NHL), a disease which may involve the spine, is frequently associated with advanced disease. Radiculopathy caused by spinal root compression as the initial presentation in patients with NHL is very rare and thought to occur in less than 5% of cases. A 69-year-old woman complained of a history of low back pain with right sciatica for 1 month prior to admission. Computed tomography and magnetic resonance imaging of the lumbar spine showed a dumbbell-shape epidural mass lesion extending from L2 to L3, which was suggestive of a neurogenic tumor. After paraspinal approach and L2 lower half partial hemilaminectomy, total excision of the tumor was achieved, followed by rapid improvement of back pain and radiating pain. The lesion was confirmed to be Burkitt's lymphoma by histopathological examination. We then checked whole-body PET-CT, which showed multifocal malignant lesions in the intestine, liver, bone and left supraclavicular lymph node. Although a rare situation, Burkitt's lymphoma should be considered in the differential diagnosis for patients presenting with back and lumbar radicular pain without a prior history of malignancy. Burkitt's lymphoma could be the cause of dumbbell-shape spinal tumor.
非霍奇金淋巴瘤（NHL）是一种可能累及脊柱的疾病，常与晚期疾病相关。NHL患者以脊髓神经根受压导致的神经根病为首发表现极为罕见，据认为发生率不到5%。一名69岁女性在入院前1个月主诉有腰痛伴右下肢坐骨神经痛病史。腰椎计算机断层扫描和磁共振成像显示从L2至L3有一个哑铃形硬膜外肿块病变，提示为神经源性肿瘤。经椎旁入路和L2下半部分半椎板切除术后，肿瘤得以完全切除，随后背痛和放射性疼痛迅速改善。组织病理学检查证实该病变为伯基特淋巴瘤。然后我们检查了全身PET-CT，结果显示肠道、肝脏、骨骼和左锁骨上淋巴结有多处恶性病变。尽管情况罕见，但对于出现背部和腰部神经根性疼痛且无既往恶性肿瘤病史的患者，鉴别诊断时应考虑伯基特淋巴瘤。伯基特淋巴瘤可能是哑铃形脊柱肿瘤的病因。
