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J Neurocrit Care 2008;1(2): 177-180.
A Case of Diffuse Large B-Cell Lymphoma Presenting as Transverse Myelopathy
Hyun Sook Kim, MD, Kyoung-Keun Kim, MD and Ok Joon Kim, MD, PhD
Department of Neurology, College of Medicine, Pochon CHA University, Seongnam, Korea
A Case of Diffuse Large B-Cell Lymphoma Presenting as Transverse Myelopathy
Hyun Sook Kim, MD Kyoung-Keun Kim, MD and Ok Joon Kim, MD, PhD
Department of Neurology, College of Medicine, Pochon CHA University, Seongnam, Korea
ABSTRACT
Background: In patients with lymphoma, transverse myelopathy can be induced by direct infiltration of tumor cells into spinal cord, ischemic cord change secondary to intravascular infiltration of tumor cells or immunogenic paraneoplastic syndrome. We report an unusual case of diffuse large B-cell lymphoma presenting as transverse myelopathy.
Case Report: A 78-year-old woman was presented with paraparesis and hypoesthesia below T6 level. C-T-L-spine magnetic resonance image (MRI) showed multiple bulging discs without signal change on spinal cord. Brain MRI and CSF study showed no specific finding. After steroid pulse therapy, paraparesis was partially improved. Two months after the onset, papaparesis and hypoesthesia were aggravated. Spine MRI showed increased signal intensities on T2-4 level without contrast enhancement. Ultrasonography-guided lymph node biopsy confirmed diffuse large B-cell lymphoma.
Conclusions: Our patient presented with only clinically suspected transverse myelopathy, which turned out to be paraneoplastic. Underlying lymphoma could be revealed byunusual clinical courses and careful physical examination.
Key Words: Paraneoplastic·Diffuse large B-cell lymphoma·Transverse myelopathy
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