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Journal of Korean Neurosurgical Society 2001;30(3): 395-399.
Primary Spinal Epidural Lymphoma Mimicking Epidural Abscess in a Diabetic.
Se Hoon Kim, Dong Jun Lim, Tai Hyoung Cho, Yong Gu Chung, Hoon Kap Lee, Ki Chan Lee, Jung Keun Suh
Department of Neurosurgery, School of Medicine, Korea University, Seoul, Korea.
Primary spinal epidural lymphoma(SEL), i.e. occurring in the absence of any detectable extraspinal lymphoproli-ferative disorder, is an unusual cause of spinal cord compression. The authors report a 48-year-old, diabetic woman presented with back pain followed by acute paraparesis and voiding difficulty. She had been treated with acupunctures on her back before admission, and complete blood count showed leukocytosis with neutrophilia and increased erythrocyte sedimentation rate(ESR). Thoracic spine magnetic resonance imaging(MRI) revealed an epidural mass extending from T5 to T8 with compression of the spinal cord. Emergency decompressive laminectomy was performed with a tentative diagnosis of spinal epidural abscess, but a B-cell lymphoma was final pathologic diagnosis. Further staging showed no other sites of lymphoma, and the spinal lesion was treated by chemotherapy and radiotherapy. The authors stress that primary SEL can mimic spinal epidural abscess(SEA) in the diabetic patient and should be a diagnostic consideration in patients with a syndrome of acute spinal cord compression manifested by a prodrome of back pain and neuroimaging consistent with an epidural compressive lesion, especially in a diabetic.
Key Words: Primary spinal epidural lymphoma; Epidural abscess; Spinal cord compression; Diabetic
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