Primary spinal T cell/histiocyte-rich large B cell lymphoma (THRLBCL)-a rare diagnosis at a rare site

Abstract

T cell/histiocyte-rich large B cell lymphoma (THRLBCL) is an unusual variant of diffuse large B cell lymphoma with poor prognosis. We describe a case of THRLBCL with an uncommon isolated spinal involvement. A 37-year-old male came to the neurosurgery outpatient department with weakness of both upper and lower limbs. Histopathology and immunohistochemistry revealed features consistent with THRLBCL. The patient was treated with D5-D6 laminectomy followed by six cycles of chemotherapy (CHOP; cyclophosphamide, hydroxydaunorubicin, oncovin, prednisolone) and was disease free for 5 years until he had relapse of disease at the same location in 2016 for which he is receiving palliative radiation therapy. Isolated spinal involvement as the first or only manifestation of THRLBCL is very rare and has been described very occasionally in the literature. It is important to correctly diagnose this entity and differentiate it from its mimics because of different prognostic and therapeutic implications.