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Case Reports
. 2020 Dec 31:13:701-705.
doi: 10.2147/IMCRJ.S291729. eCollection 2020.

Primary Intradural Extramedullary Spinal Burkitt's Lymphoma: A Case Report

Senai Goitom Sereke  1 , Felix Bongomin  2   3 , Zeridah Muyinda  4
Affiliations
Case Reports

Primary Intradural Extramedullary Spinal Burkitt's Lymphoma: A Case Report

Senai Goitom Sereke et al. Int Med Case Rep J. .

Abstract

Background: Non-Hodgkin's lymphoma (NHL) rarely involves the spine primarily, and if it does, is almost always associated with advanced disease.

Case presentation: An 8-year-old male presented with a one month history of nuchal pain followed by stiffness and rapidly progressive upper and lower limb weakness. He was seronegative for HIV and EBV. Computed tomography myelogram and magnetic resonance imaging of the cervical and thoracic spine showed a long segment (C2 to T1) complete absence of cerebrospinal fluid signal and mildly enhancing intradural extramedullary lesion with an extradural and right paravertebral muscle extension, respectively. Post-excision biopsy histopathology and immunohistochemistry confirmed the diagnosis of a CD 10+, CD20+, CD45+, Bcl-2+, Ki67+, and EBER in situ hybridization for EBV negative, Burkitt's lymphoma (BL). Cytogenetic analysis showed chromosomal translocations of 8q24. CHOP plus intrathecal cytarabine, methotrexate was given as chemotherapy regimen. 1.8 grays (Gy) per fraction to the local area for an average total dose of 36 Gy was given with a resultant significant clinical improvement.

Conclusion: Though considered uncommon spinal canal tumors, BL should be in the differential diagnosis, if multilevel involvement is demonstrated on imaging.

Keywords: extramedullary; intradural; non-Hodgkin’s lymphoma (Burkitt’s); spinal.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
(A) T2 mid-sagittal (B) T1 mid-sagittal (C) STIR mid-sagittal (D) T1+C mid-sagittal, demonstrated an infiltrating intradural extramedullary, isointense on T1 and hyper intense on T2, mildly enhancing spinal cord lesion involving C2-C4 with an extension to extradural space of C3-T2.
Figure 2
Figure 2
(A) T1 axial at C2 (B) T1 axial at C4 (C) T1+C at C4, demonstrated circumferential enhancing lesion in the intradural and extramedullary space with severe spinal stenosis (blue arrow), the lesion exits the spinal canal via neural exit foramina (black arrow), extended to the right semispinalis cervicis, semispinalis capitis, trapezius, lavatory scapulae and the anterior scalene muscles (white arrow).
Figure 3
Figure 3
(A) MRI myelogram (B) CT myelogram coronal (C). CT myelogram mid-sagittal, demonstrated a complete absence of contrast (broken stick appearance of conventional myelography) in the leptomeningeal space from C2 to T1 while uniform ossification of the space below T1.
Figure 4
Figure 4
Immunohistochemistry demonstrated positivity of CD45, CD20 and Ki 67 which were features of high-grade B cell lymphoma.
See this image and copyright information in PMC

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