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Review
. 2023 Jun 6;18(2):231-245.
doi: 10.1055/s-0043-1768574. eCollection 2023 Jun.

B-Cell Lymphoma Intramedullary Tumor: Case Report and Systematic Review

Daniel Gregório Gonsalves  1 , Paulo Eduardo Albuquerque Zito Raffa  1 , Gabriela Gerenutti de Sousa  2 , Melissa Esposito Gomes Rigueiral  3 , Iracema Araújo Estevão  4 , Cesar Cozar Pacheco  4 , Roger Thomaz Rotta Medeiros  4 , Paulo Roberto Franceschini  5 , Paulo Henrique Pires de Aguiar  4   6   7
Affiliations
Review

B-Cell Lymphoma Intramedullary Tumor: Case Report and Systematic Review

Daniel Gregório Gonsalves et al. Asian J Neurosurg. .

Abstract

Intramedullary tumors represent the major cause of spinal cord injuries, and its symptoms include pain and weakness. Progressive weakness may concomitantly occur in the upper and lower limbs, along with lack of balance, spine tenderness, sensory loss, trophic changes of extremity, hyperreflexia, and clonus. The study protocol was in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A systematic search of the MEDLINE electronic database was performed to identify the studies reporting the clinical features of children and adults who presented with an intramedullary lymphoma. Twenty-one studies were included, reporting 25 cases. Manuscripts were excluded if the full-text article was not available, original data were not reported (e.g., review articles), or if the main disease was not intramedullary lymphoma. A structured data extraction form was employed to standardize the identification and retrieval of data from manuscripts. To enlighten the discussion, a case is also presented. An 82-year-old woman with Fitzpatrick skin type II, diagnosed and treated for non-Hodgkin's lymphoma 7 years ago, was admitted with mental confusion and memory loss for the past 2 months-evolving with recurring falls from her own height. One day before admission, she displayed Brown-Séquard syndrome. An expansive lesion from C2 to C4 in the cervical spinal cord was found and a hypersignal spinal cord adjacent was described at the bulb medullary transition to the C6-C7 level. A primary spinal cord tumor was considered, as well as a melanoma metastasis, due to the lesion's flame pattern. The patient presented a partial recovery of symptoms and a reduction of the spinal cord edema after being empirically treated with corticosteroids, but the lesion maintained its extent. Subsequently, a large diffuse B-cell lymphoma with nongerminal center was found in open body biopsy, infiltrating neural tissue. The main objective of the present study is to report a surgical case treated for a large diffuse B-cell lymphoma, in addition to presenting the results of a systematic review of primary intramedullary spinal cord lymphoma.

Keywords: diffuse; large B cell; lymphoma; neurosurgery; spinal cord neoplasms.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Flow diagram of the systematic reviews and articles included.
Fig. 2
Fig. 2
( A ) Precorticotherapy sagittal postcontrast magnetic resonance imaging (MRI). ( B ) Precorticotherapy axial T1 postcontrast.
Fig. 3
Fig. 3
( A ) Five days after corticotherapy: sagittal T1 postcontrast magnetic resonance imaging (MRI). ( B ) Five days after corticotherapy: axial T1 postcontrast MRI.
Fig. 4
Fig. 4
Postbiopsy axial T1 postcontrast magnetic resonance imaging (MRI).
Fig. 5
Fig. 5
Tumor resection: intraoperative image.
See this image and copyright information in PMC

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