Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
A Case of Neurolymphomatosis in the cauda Equina Diagnosed by an Open Biopsy
Ryo SasakiYasuyuki OhtaYuto YamadaKoh TadokoroYoshiaki TakahashiKota SatoJingwei ShangMami TakemotoNozomi HishikawaToru YamashitaTakao YasuharaIsao DateShuntaro IkegawaNobuharu FujiiKoji Abe
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JOURNALS OPEN ACCESS Advance online publication

Article ID: 1049-18

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Abstract

Neurolymphomatosis is a rare form of extranodal malignant lymphoma defined as the infiltration of malignant lymphocytes into the central or peripheral nerve. We herein report a case of neurolymphomatosis in the cauda equina diagnosed by an open surgical biopsy. He presented with muscle weakness, atrophy, numbness and hypoesthesia in the bilateral lower extremities with the accumulation of 18fluoro-2-deoxyglucose (FDG) in the bilateral cauda equina. Cerebrospinal fluid (CSF) cytology (three times) and flow cytometry (two times) and biopsies of the left sural nerve, bone marrow, paranasal sinus and left testis were all negative for malignancy, so finally we performed a surgical open biopsy of the cauda equina by laminectomy and diagnosed him with diffuse large B-cell lymphoma (DLBCL) in the cauda equina. He was successfully treated with the disappearance of the FDG accumulation for a long time. The present case suggested that an early open biopsy of the cauda equina may be considered for cases of suspected neurolymphomatosis in the cauda equina for a good outcome.

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© 2019 by The Japanese Society of Internal Medicine
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