Primary Spinal Marginal Zone Lymphoma Presenting With Spinal Cord Compression: A Case Report

Extranodal marginal zone lymphoma (EMZL) is an indolent B-cell lymphoma that typically arises in mucosal or extranodal tissues. Spinal involvement is exceptionally rare and may present with spinal cord compression, posing diagnostic and therapeutic challenges. We report the case of a 70-year-old man who presented with progressive paraparesis following a four-month history of lumbosciatic pain. MRI revealed an epidural and paravertebral mass extending from L2 to L4 with vertebral body destruction and spinal canal invasion. Urgent decompressive laminectomy with subtotal resection was performed. Histopathology and immunohistochemistry confirmed EMZL. Staging excluded systemic disease. The patient received adjuvant radiotherapy (24 Gy in 12 fractions) using volumetric modulated arc therapy (VMAT). Treatment was well tolerated, with neurological recovery and a good clinical outcome. Spinal EMZL is a rare cause of spinal compression. Accurate diagnosis requires integrated histopathologic and immunophenotypic evaluation. Combined surgical decompression and standard-dose radiotherapy can provide effective local control and favorable outcomes.