Primary cauda equina lymphoma diagnosed by nerve biopsy: A case report and literature review

Suzuki,Kayo; Yasuda,Taketoshi; Hiraiwa,Toshihito; Kanamori,Masahiko; Kimura,Tomoatsu; Kawaguchi,Yoshiharu

doi:10.3892/ol.2018.8629

Primary cauda equina lymphoma diagnosed by nerve biopsy: A case report and literature review

Authors:
- Kayo Suzuki
- Taketoshi Yasuda
- Toshihito Hiraiwa
- Masahiko Kanamori
- Tomoatsu Kimura
- Yoshiharu Kawaguchi
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Affiliations: Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Toyama 930‑0194, Japan, Department of Human Science 1, Faculty of Medicine, University of Toyama, Toyama, Toyama 930‑0194, Japan
Published online on: May 4, 2018 https://doi.org/10.3892/ol.2018.8629
Pages: 623-631

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Abstract

Primary cauda equina lymphoma (CEL) is a rare malignant tumor among various neoplasms that affects the cauda equina nerve roots. The present case report described the case of a 65‑year‑old man who presented with cauda equina syndrome with progressive motor palsy in the legs and gait disturbance over the last 5 months. Magnetic resonance (MR) images showed enlargement of the cauda equina occupying the dural sac from the L1‑S1 level with isointensity to the spinal cord signal on both T1‑ and T2‑weighted imaging. Enhancement of the cauda equina was seen on contrast MR images. On F‑18 2‑fluoro‑2‑deoxy‑glucose positron emission tomography examination, diffuse accumulation of 2‑fluoro‑2‑deoxy‑glucose was observed in the cauda equina with a maximum standardized uptake value of 4.9. Based on elevation of soluble interleukin 2 receptor in cerebrospinal fluid and a biopsy of the enlarging cauda equina, a diagnosis of CEL of the diffuse large B‑cell type was made. The present case report provided a detailed case discussion and a review of the available literature on this rare entity, focusing on clinical characteristics and imaging of primary CEL.

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