Long Spinal Cord Lesions Caused by Venous Congestive Myelopathy Associated with Intravascular Large B-cell Lymphoma

Takeshi Miura; Shoji Saito; Rie Saito; Tomohiro Iwasaki; Naomi Mezaki; Tomoe Sato; Yoichi Ajioka; Akiyoshi Kakita; Takuya Mashima

doi:10.2169/internalmedicine.6717-20

CASE REPORTS

Long Spinal Cord Lesions Caused by Venous Congestive Myelopathy Associated with Intravascular Large B-cell Lymphoma

Takeshi Miura, Shoji Saito, Rie Saito, Tomohiro Iwasaki, Naomi Mezaki, Tomoe Sato, Yoichi Ajioka, Akiyoshi Kakita, Takuya Mashima

Author information

Takeshi Miura
Department of Neurology, Tsubame Rosai Hospital, Japan
Shoji Saito
Department of Pathology, Brain Research Institute, Niigata University, Japan
Department of Neurosurgery, Brain Research Institute, Niigata University, Japan
Rie Saito
Department of Pathology, Brain Research Institute, Niigata University, Japan
Tomohiro Iwasaki
Department of Internal Medicine, Tsubame Rosai Hospital, Japan
Naomi Mezaki
Department of Neurology, Tsubame Rosai Hospital, Japan
Tomoe Sato
Department of Neurology, Tsubame Rosai Hospital, Japan
Yoichi Ajioka
Division of Molecular and Diagnostic Pathology Graduate School of Medical and Dental Sciences, Niigata University, Japan
Akiyoshi Kakita
Department of Pathology, Brain Research Institute, Niigata University, Japan
Takuya Mashima
Department of Neurology, Tsubame Rosai Hospital, Japan

Keywords: intravascular lymphoma, IVL, IVLBCL, MALT lymphoma, long spinal cord lesion, venous congestive myelopathy

JOURNAL OPEN ACCESS

2021 Volume 60 Issue 23 Pages 3809-3816

DOI https://doi.org/10.2169/internalmedicine.6717-20

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Abstract

Intravascular large B-cell lymphoma (IVLBCL) is a subtype of B-cell lymphoma, characterized by lymphoma cell proliferation within small blood vessels. We herein describe a rare case with long spinal cord lesions caused by venous congestive myelopathy associated with IVLBCL. An 81-year-old man presented with paraplegia of the lower limbs and sensory disturbances. Magnetic resonance imaging revealed intramedullary longitudinal T2-hyperintensity lesions in the thoracic cords. The patient died three months after disease onset, and a neuropathological analysis revealed predominantly atypical B-lymphocytes located sparsely in the veins of the spinal cord. IVLBCL should be considered in the differential diagnoses of long spinal cord lesions.

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