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CC BY-NC-ND 4.0 · Asian J Neurosurg 2023; 18(02): 231-245
DOI: 10.1055/s-0043-1768574
Review Article

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

Daniel Gregório Gonsalves 
1   Graduation Medicine at Faculty of Medicine of Catanduva, Catanduva, São Paulo, Brazil
,
Paulo Eduardo Albuquerque Zito Raffa
1   Graduation Medicine at Faculty of Medicine of Catanduva, Catanduva, São Paulo, Brazil
,
Gabriela Gerenutti de Sousa
2   Graduation Medicine at Pontifical Catholic University of São Paulo, Sorocaba, Brazil
,
Melissa Esposito Gomes Rigueiral
3   Graduation Medicine at Faculty of Medicine of ABC, Santo André, São Paulo, Brazil
,
Iracema Araújo Estevão
4   Department of Neurosurgery, Santa Paula Hospital, São Paulo, Brazil
,
Cesar Cozar Pacheco
4   Department of Neurosurgery, Santa Paula Hospital, São Paulo, Brazil
,
Roger Thomaz Rotta Medeiros
4   Department of Neurosurgery, Santa Paula Hospital, São Paulo, Brazil
,
Paulo Roberto Franceschini 
5   Department of Neurosurgery, University of Caxias do Sul, Rio Grande do Sul, Brazil
,
Paulo Henrique Pires de Aguiar
4   Department of Neurosurgery, Santa Paula Hospital, São Paulo, Brazil
6   Department of Research and Innovation, Laboratory of Cellular and Molecular Biology, Faculty of Medicine of ABC, Santo André, São Paulo, Brazil
7   Department of Neurology, School of Medicine of Pontifical Catholic University of São Paulo, Sorocaba, São Paulo, Brazil
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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

spinal cord neoplasms - lymphoma - large B cell - diffuse - neurosurgery


Publication History

Article published online:
06 June 2023

© 2023. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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