Pérez-Martínez D A, Saiz-Díaz R A, de Toledo M, Berbel A, Martínez-Salio A, Prieto S
Servicio de Neurología, Hospital Universitario 12 de Octubre, Madrid, España.
Rev Neurol. 1998 Jul;27(155):91-3.
Neurological involvement in no-Hodgkin lymphoma is usually a serious problem leading to subacute compression of the spinal cord secondary to invasion of the spinal extradural space. This condition may be the presenting form of the illness, although relatively infrequently. Onset with involvement of the cauda equina or as an isolated radiculopathy is even rarer and has mainly been described at lumbar level.
We present the case of a 27 year old man with no significant previous clinical history who had progressive, insidious onset of moderate-serious senso-motor radiculopathy at C8. On MR there was an infiltrating mass affecting the nerve root and reaching the spinal extradural space. Following decompression laminectomy the patient's leg recovered and on histology there was a large cell B lymphoma. The other complementary tests showed disseminated disease, although analysis of the cerebro-spinal fluid (including cytology) was normal. HIV seriology was also normal.
Although isolated nerve root involvement is unusual in the presentation of lymphoma it should be considered to be part of the differential diagnosis of nerve root syndromes in young patients with no history of trauma or degenerative lesions.
非霍奇金淋巴瘤累及神经系统通常是一个严重问题，可导致脊髓硬膜外间隙受侵继发脊髓亚急性受压。这种情况可能是疾病的首发表现，尽管相对少见。以马尾受累或孤立性神经根病起病的情况更为罕见，主要见于腰椎水平。
我们报告一例27岁男性患者，既往无显著临床病史，逐渐隐匿起病，出现C8节段中度至重度感觉运动性神经根病。磁共振成像显示有一浸润性肿块累及神经根并延伸至脊髓硬膜外间隙。行减压性椎板切除术后患者腿部功能恢复，组织学检查显示为大细胞B淋巴瘤。其他辅助检查显示有播散性病变，尽管脑脊液分析（包括细胞学检查）正常。HIV血清学检查也正常。
尽管孤立性神经根受累在淋巴瘤表现中不常见，但对于无创伤或退行性病变病史的年轻患者，在神经根综合征的鉴别诊断中应考虑到这一情况。
