Non-Hodgkin Lymphoma With Longitudinally Extensive Transverse Myelopathy as the Initial Symptom: A Case Report
Conclusions
DLBCL, the most common type of NHL, occurs primarily in middle-aged or elderly patients. The median age at the time of diagnosis is in the 7th decade (1). Gastrointestinal tract is the most common site of lymphoma. NHL confined to the brain, leptomeninges, spinal cord, or eyes without evidence of systemic involvement, is called primary CNS lymphoma. Primary CNS lymphoma is rare and aggressive, accounting for 1% of all lymphomas (3). If the spinal cord is involved, primary CNS lymphoma is often found to have occult systemic involvement (4). Therefore, it is very rare for systemic NHL to present with acute extensive myelitis as the initial manifestation, as it was the case in this report.
Single mass lesion is the most common manifestation of CNS lymphoma (3). It can also occur with a variable and atypical imaging appearance, rendering the diagnosis unusually challenging. The brain lesions of our patient were diffuse without mass effect or edema, and were located mainly in the medial temporal lobe. The patient presented with acute onset of mild personality changes, leading us to suspect presence of autoimmune encephalitis. Spinal cord involvement has been reported in autoimmune encephalitis, though is considered to be very rare. Extensive myelitis has been reported to be associated with anti-NMDA receptor antibodies (5, 6). The failure to detect autoimmune antibodies in the CSF or serum prompted us to consider other differential diagnoses.
The clinical features o...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
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