Lyons M K, O'Neill B P, Kurtin P J, Marsh W R
Department of Neurologic Surgery, Mayo Clinic Scottsdale, Arizona 85259, USA.
Mayo Clin Proc. 1996 May;71(5):453-7. doi: 10.4065/71.5.453.
To describe the diagnosis, management, and outcome in 10 patients with histologically confirmed primary spinal epidural non-Hodgkin's lymphoma.
We review the findings in a cohort of seven men and three women in whom this tumor was diagnosed between January 1979 and January 1993 and discuss the prognostic differences between primary and secondary spinal lymphomas.
All patients (median age at diagnosis, 70 years) underwent a decompressive laminectomy, subtotal tumor resection, and spinal irradiation (median dose, 3,800 cGy). Nine of 10 tumors were of B-cell origin. Six patients are alive and well. In four patients, recurrent disease developed from 15 to 62 months after the original diagnosis; of these, one has died. The median duration of survival of all patients was 42 months; of those living more than 24 months after diagnosis, the median duration of survival was 80 months.
A rapidly progressive spinal cord or cauda equina syndrome with neuroimaging findings consistent with an extradural compressive lesion should alert caregivers to the possibility of spinal epidural lymphoma. Although the prognosis for patients with secondary spinal epidural non-Hodgkin's lymphoma is often poor, primary spinal epidural non-Hodgkin's lymphoma can be associated with a favorable outcome if diagnosed and treated early.
描述10例经组织学确诊的原发性脊柱硬膜外非霍奇金淋巴瘤患者的诊断、治疗及预后情况。
我们回顾了1979年1月至1993年1月期间诊断出该肿瘤的7名男性和3名女性患者的资料，并讨论原发性和继发性脊柱淋巴瘤的预后差异。
所有患者（诊断时的中位年龄为70岁）均接受了减压性椎板切除术、肿瘤次全切除术及脊柱照射（中位剂量为3800 cGy）。10例肿瘤中有9例起源于B细胞。6例患者存活且状况良好。4例患者在初次诊断后15至62个月出现疾病复发，其中1例已死亡。所有患者的中位生存期为42个月；诊断后存活超过24个月的患者，中位生存期为80个月。
出现快速进展的脊髓或马尾综合征且神经影像学检查结果与硬膜外压迫性病变相符时，应提醒医护人员注意脊柱硬膜外淋巴瘤的可能性。尽管继发性脊柱硬膜外非霍奇金淋巴瘤患者的预后通常较差，但原发性脊柱硬膜外非霍奇金淋巴瘤若能早期诊断并治疗，可能会有较好的预后。
