Primary lumbar spinal epidural b-lymphoblastic lymphoma: A case report

Abstract

Background: Primary spinal epidural non-Hodgkin’s lymphoma (PSENHL) is an uncommon disease. Most PSENHL are diffuse large B-cell lymphomas, and thoracic spine is the most common site of involvement. Primary spinal epidural B-Lymphoblastic Lymphoma (LBL) is particularly rare. So far only one case at thoracic segment was reported. Case presentation: A 16-year-old female presented with a history of pain in her lower back and lower extremities for 7 d, pain aggravated and weakness for 4 d, urinary incontinence for 2 d. Magnetic Resonance Imaging (MRI) scan revealed an extradural mass lesion at L3 to L5 level, which was at first suggestive of a neurogenic tumor. L4-L5 laminectomy was performed and tumor was totally resected. Histopathological examination after surgery revealed B-lymphoblastic lymphoma (LBL)/-Acute Lymphoblastic Leukemia (ALL). Postoperative blood counts, bone marrow biopsy and aspiration were negative. The final diagnosis of primary spinal epidural B-LBL was made. Patient was treated with vincristine, daunorubicin, cyclophosphamide, L-asparaginase and prednisone after surgery. After 2 months of follow up, all the symptoms were relieved. Conclusion: Primary spinal epidural non-Hodgkin’s lymphoma should be considered in the differential diagnosis of the patients who present with spinal cord or cauda equina compression. This is the first primary spinal epidural B-LBL at lumbar reported as we known.