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

Daniel Gregório Gonsalves; Paulo Eduardo Albuquerque Zito Raffa; Gabriela Gerenutti de Sousa; Melissa Esposito Gomes Rigueiral; Iracema Araújo Estevão; Cesar Cozar Pacheco; Roger Thomaz Rotta Medeiros; Paulo Roberto Franceschini; Paulo Henrique Pires de Aguiar

doi:10.1055/s-0043-1768574

Asian Journal of Neurosurgery, Table of Contents

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

Authors

Daniel Gregório Gonsalves

¹Graduation Medicine at Faculty of Medicine of Catanduva, Catanduva, São Paulo, Brazil
Paulo Eduardo Albuquerque Zito Raffa

¹Graduation Medicine at Faculty of Medicine of Catanduva, Catanduva, São Paulo, Brazil
Gabriela Gerenutti de Sousa

²Graduation Medicine at Pontifical Catholic University of São Paulo, Sorocaba, Brazil
Melissa Esposito Gomes Rigueiral

³Graduation Medicine at Faculty of Medicine of ABC, Santo André, São Paulo, Brazil
Iracema Araújo Estevão

⁴Department of Neurosurgery, Santa Paula Hospital, São Paulo, Brazil
Cesar Cozar Pacheco

⁴Department of Neurosurgery, Santa Paula Hospital, São Paulo, Brazil
Roger Thomaz Rotta Medeiros

⁴Department of Neurosurgery, Santa Paula Hospital, São Paulo, Brazil
Paulo Roberto Franceschini

⁵Department of Neurosurgery, University of Caxias do Sul, Rio Grande do Sul, Brazil
Paulo Henrique Pires de Aguiar

⁴Department of Neurosurgery, Santa Paula Hospital, São Paulo, Brazil

⁶Department of Research and Innovation, Laboratory of Cellular and Molecular Biology, Faculty of Medicine of ABC, Santo André, São Paulo, Brazil

⁷Department of Neurology, School of Medicine of Pontifical Catholic University of São Paulo, Sorocaba, São Paulo, Brazil

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

Full Text

References

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