Primary Intramedullary Malignant Lymphoma in the Cervical Cord with a Presyrinx State.
Primary Intramedullary Malignant Lymphoma in the Cervical Cord with a Presyrinx State.
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DOI：
10.7759/cureus.2006
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发表时间：
2017-12-30
期刊：
影响因子：
--
通讯作者：
Ogasawara K
中科院分区：
文献类型：
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作者：
Chida K;Sugawara A;Koji T;Beppu T;Mue Y;Sugai T;Ogasawara K
摘要一位79岁男性病患因原发性髓内恶性淋巴瘤而出现颈髓前病变，表现为左侧轻偏瘫及偏侧感觉迟钝。磁振造影扫描显示在颈髓C1位有一髓内肿块，T2加权影像从髓部延伸至C5位。根据轻偏瘫的进展，他在全身麻醉下接受了紧急肿瘤切除术。肿瘤被完全切除，并且在术后MRI中不存在瘤周信号异常。组织学检查显示弥漫性大B细胞淋巴瘤。虽然进行了脑部MRI、骨髓穿刺和全身18 F-氟脱氧葡萄糖正电子发射断层扫描（18 FDG-PET）以发现原发性病变，但没有异常。他接受了高剂量的甲氨蝶呤为基础的化疗和局部放射治疗（40 Gy）。自症状出现以来，他已经活了两年多，没有任何复发的证据。本病例提示恶性淋巴瘤为浸润性、进展迅速的肿瘤，可伴发空洞。
A 79-year-old man presented with primary intramedullary malignant lymphoma with a presyrinx state in the cervical cord manifesting as left hemiparesis and hemidysesthesia. The magnetic resonance imaging (MRI) scan showed an intramedullary mass in the cervical spinal cord at the level of C1 and T2-weighted image prolongation from the medulla to the level of C5. According to the progression of hemiparesis, he underwent an emergency removal of the tumor under general anesthesia. The tumor was totally removed, and the peritumoral signal abnormality was not present in the postoperative MRI. Histological examination revealed diffuse large B cell lymphoma. While brain MRI, bone marrow puncture, and 18F-fluorodeoxy-glucose positron emission tomography (18FDG-PET) of the whole body were performed to find out a primary lesion, there were no abnormalities. He underwent a high-dose methotrexate-based chemotherapy and a local irradiation therapy (40Gy). He has been alive for more than two years since the symptom onset, and without any evidence of recurrence. This case suggests that malignant lymphoma, as an infiltrating and rapidly progressive tumor, may be accompanied by syrinx.