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[A case of intravascular malignant lymphomatosis presenting as slowly progressive paraplegia]
Naoki Nakao1, Mari Yoshida, Manabu Iwata
1Department of Neurology, Aichi M School of Medicine, 21 Karimata Yazako, Nagakute cho, Aichi gun, Aichi 480-1195, Japan.
Abstract:
We present a case of a 62-year-old female was admitted with complaints of slowly developing paraplegia ascending from the distal portions, and a 7-month history of recto-urinary dysfunction. T2-weighted magnetic resonanse imaging (MRI) of the spinal cord showed hyperintense lesions in the thoracic and sacral cord. Multiple sclerosis was assumed, and steroid pulse therapy was therefore administered: this temporarily improved the symptoms and imaging findings. However, the symptoms recurred in 2 months. The patient died after ineffective steroid therapy. Large B-cell lymphoma cells were identified on bone marrow biopsy. Macroscopic neuropathology revealed neoplastic cells in the blood vessels of the cauda equina. Paraplegia appeared to have developed slowly and in a non-stepwise manner, since the cauda equina has been gradually invaded by intravascular malignant lymphomatosis.
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