Primary Lumbo-sacral Spinal Epidural Non-Hodgkin's Lymphoma: A Case Report and Review of Literature

Abstract

We present a case of 24-year-old male presented with low back pain radiating to the left lower limb, tingling numbness and weakness of 6 months duration. Magnetic resonance imaging scan with contrast reveals an extradural mass at lumbosacral region. Patient was operated with laminectomy and complete excision of the lesion was done. Patient's radicular pain relieved following the surgery and weakness also improved. Histopathology was suggestive of non-Hodgkin's lymphoma. Patient received chemotherapy which was followed by radiotherapy. Primary Non-Hodgkin's lymphoma of the lumbosacral spinal epidural tissue is an uncommon lesion. Lymphoma involves the central nervous system in 5-11% of cases either at presentation of the disease or during its course. The spinal epidural tissue is involved primarily in 0.1-3.3% of cases with spinal cord compression being the commonest presentation. Excision of the lesion followed by chemotherapy and radiotherapy is required to achieve cure.

Keywords: Epidural; Lumbosacral region; Non-Hodgkin's lymphoma; Spinal.

Fig. 1

Magnetic resonance imaging scan (sagittal view) showing well defined lobulated mass lesion L5-S1 to mid S2 level. The lesion was iso- to hypo-intense on T1 weighted images.

Fig. 2

Magnetic resonance imaging scan (sagittal view) showing well defined lobulated lesion. The lesion was iso- to hypo-intense on T2 weighted images.

Fig. 3

Magnetic resonance imaging scan (axial view) showing well defined lesion in the intraspinal canal traversing the left neural foramina and compressing the left nerve root.