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• Vol.61 No.12
• CLINICA NEUROL, 61: 856−861, 2021
• Vol.61 No.12 contents

Case Report

A case of primary intramedullary spinal cord lymphoma diagnosed by spinal cord biopsy of long spinal cord lesions showing persistent gadolinium contrast enhancement

Atsushi Okano, M.D.¹⁾, Masahiro Kanai, M.D.¹⁾, Takanobu Kita, M.D.¹⁾,Yoshiyuki Nakai, M.D.¹⁾, Hiroaki Okada, M.D.¹⁾ and Keiji Yamaguchi, M.D., Ph.D.¹⁾

¹⁾ Department of Neurology, Ichinomiya-Nishi Hospital

An 82-year-old man presented with subacute bilateral lower limb paralysis, deep sensory disturbance, and vesicorectal disturbance. MRI of the spinal cord revealed a large gray matter-dominant lesion extending from the medulla oblongata to the lower thoracic spinal cord. The patient was treated with steroid-pulse therapy for myelitis, but without symptomatic improvement. A spinal cord biopsy was performed for treatment-resistant myelopathy, and histopathology revealed a diffuse large B-cell lymphoma, that was diagnosed as a primary intramedullary spinal cord lymphoma because systemic examination didn't show any other findings suggestive of malignant lymphoma. A spinal cord biopsy is necessary for the definitive diagnosis of this disease, but in the case of poor response to treatment and a progressive course, intramedullary malignant lymphoma should be considered if there is a persistent elevation of CSF IL-10 or a prolonged contrast effect.
Full Text of this Article in Japanese PDF (2886K)

(CLINICA NEUROL, 61: 856−861, 2021)
key words: myelopathy, primary intramedullary spinal cord lymphoma, diffuse large B-cell lymphoma, interleukin 10, spinal cord biopsy

(Received: 12-Jun-21)