Evaluation and Treatment of Primary Spinal Epidural Lymphoma Presenting as Acute Myelopathy in a Young Adult: A Case Report.

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Citation: Jbjs Case Connector. 13(3), 2023 07 01.PMID: 37590426Institution: MedStar Southern Maryland HospitalDepartment: MedStar Georgetown University Hospital/MedStar Washington Hospital Center | Orthopaedic Surgery ResidencyForm of publication: Journal ArticleMedline article type(s): Case Reports | Journal ArticleSubject headings: *Bone Marrow Diseases | *Lymphoma, Large B-Cell, Diffuse | *Musculoskeletal Diseases | *Spinal Cord Compression | *Spinal Cord Diseases | Adult | Humans | Lymphoma, Large B-Cell, Diffuse/co [Complications] | Lymphoma, Large B-Cell, Diffuse/dg [Diagnostic Imaging] | Male | Spinal Cord Compression/dg [Diagnostic Imaging] | Spinal Cord Compression/et [Etiology] | Spinal Cord Compression/su [Surgery] | Young Adult | Year: 2023ISSN:
  • 2160-3251
Name of journal: JBJS case connectorAbstract: CASE: Primary spinal epidural lymphoma (PSEL) presenting as myelopathy is extremely rare, particularly within young, healthy adults. This case report describes a 26-year-old man presenting with progressive thoracic myelopathy. Magnetic resonance imaging revealed spinal epidural masses spanning T5-T10 and T12-L2 with multilevel cord compression and edema. After evaluation, the patient underwent emergent posterior decompression to prevent progressive neurological decline. Histology was consistent with diffuse large B-cell lymphoma, germinal center type. At 3 months postoperatively, the patient regained full neurologic function.CONCLUSION: Although rare, PSELs should be considered in patients presenting with myelopathy to facilitate timely diagnosis and treatment. Copyright © 2023 by The Journal of Bone and Joint Surgery, Incorporated.All authors: Cowley RA, Carroll AH, Pasko KBD, Rubenstein E, Tagouri YM, Weiner DFiscal year: FY2024Digital Object Identifier: ORCID: Date added to catalog: 2023-11-22
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Journal Article MedStar Authors Catalog Article 37590426 Available 37590426

CASE: Primary spinal epidural lymphoma (PSEL) presenting as myelopathy is extremely rare, particularly within young, healthy adults. This case report describes a 26-year-old man presenting with progressive thoracic myelopathy. Magnetic resonance imaging revealed spinal epidural masses spanning T5-T10 and T12-L2 with multilevel cord compression and edema. After evaluation, the patient underwent emergent posterior decompression to prevent progressive neurological decline. Histology was consistent with diffuse large B-cell lymphoma, germinal center type. At 3 months postoperatively, the patient regained full neurologic function.

CONCLUSION: Although rare, PSELs should be considered in patients presenting with myelopathy to facilitate timely diagnosis and treatment. Copyright © 2023 by The Journal of Bone and Joint Surgery, Incorporated.

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