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Non-Hodgkin lymphomas presenting with spinal epidural involvement
A Di Marco1, F Campostrini, G F Garusi
1Department of Radiation Oncology, Ospedale Civile Maggiore, Verona, Italy.
Acta Oncologica (Stockholm, Sweden)
|January 1, 1989
Summary
Spinal cord compression is a rare but aggressive presenting symptom of non-Hodgkin lymphoma. Intensive treatment combining surgery, radiotherapy, and chemotherapy is recommended for better outcomes.
Area of Science:
- Oncology
- Neurology
- Hematology
Background:
- Non-Hodgkin lymphoma (NHL) can present with spinal cord compression.
- This presentation is often associated with aggressive disease and unfavorable histology.
Purpose of the Study:
- To analyze the outcomes of patients with non-Hodgkin lymphoma presenting with spinal cord compression.
- To evaluate the effectiveness of different treatment modalities.
Main Methods:
- Retrospective review of 299 previously undiagnosed non-Hodgkin lymphomas between 1972 and 1987.
- Analysis of presenting symptoms, histologic diagnosis, staging, and treatment received (surgery, radiotherapy, chemotherapy).
Main Results:
- Nine out of 299 patients presented with spinal cord compression.
- All patients had unfavorable histology; stages varied, with some not fully staged.
- Only 2 of 9 patients achieved long-term disease-free survival after treatment with surgery and radiotherapy; chemotherapy was used sparingly.
- Seven patients died with disease progression despite initial remission in two cases.
Conclusions:
- Non-Hodgkin lymphoma with spinal epidural presentation is typically aggressive.
- An intensive treatment approach combining surgery, radiotherapy, and chemotherapy is suggested for improved local and long-term results.
- Surgical intervention often involves laminectomy and biopsy.