Goitom Sereke Senai, Bongomin Felix, Muyinda Zeridah
Department of Radiology and Radiotherapy, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
Int Med Case Rep J. 2020 Dec 31;13:701-705. doi: 10.2147/IMCRJ.S291729. eCollection 2020.
Non-Hodgkin's lymphoma (NHL) rarely involves the spine primarily, and if it does, is almost always associated with advanced disease.
An 8-year-old male presented with a one month history of nuchal pain followed by stiffness and rapidly progressive upper and lower limb weakness. He was seronegative for HIV and EBV. Computed tomography myelogram and magnetic resonance imaging of the cervical and thoracic spine showed a long segment (C2 to T1) complete absence of cerebrospinal fluid signal and mildly enhancing intradural extramedullary lesion with an extradural and right paravertebral muscle extension, respectively. Post-excision biopsy histopathology and immunohistochemistry confirmed the diagnosis of a CD 10+, CD20+, CD45+, Bcl-2+, Ki67+, and EBER in situ hybridization for EBV negative, Burkitt's lymphoma (BL). Cytogenetic analysis showed chromosomal translocations of 8q24. CHOP plus intrathecal cytarabine, methotrexate was given as chemotherapy regimen. 1.8 grays (Gy) per fraction to the local area for an average total dose of 36 Gy was given with a resultant significant clinical improvement.
Though considered uncommon spinal canal tumors, BL should be in the differential diagnosis, if multilevel involvement is demonstrated on imaging.
非霍奇金淋巴瘤（NHL）很少原发累及脊柱，若累及脊柱，几乎总是与晚期疾病相关。
一名8岁男性，有1个月颈部疼痛病史，随后出现僵硬以及快速进展的上下肢无力。他的HIV和EBV血清学检测均为阴性。颈椎和胸椎的计算机断层扫描脊髓造影和磁共振成像显示长节段（C2至T1）完全没有脑脊液信号，硬膜内髓外病变轻度强化，分别伴有硬膜外和右侧椎旁肌肉延伸。切除术后活检组织病理学和免疫组化确诊为CD10 +、CD20 +、CD45 +、Bcl-2 +、Ki67 +，EBV原位杂交阴性的伯基特淋巴瘤（BL）。细胞遗传学分析显示8q24染色体易位。化疗方案为CHOP加鞘内注射阿糖胞苷、甲氨蝶呤。对局部区域给予每次1.8戈瑞（Gy），平均总剂量为36 Gy，临床症状得到显著改善。
尽管伯基特淋巴瘤被认为是罕见的椎管肿瘤，但如果影像学显示多节段受累，在鉴别诊断中应考虑该病。
