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Spinal cord compression by primary non-Hodgkin's lymphoma
K C Lakshmaiah1, D Lokanath, T M Suresh
1Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India.
Indian Journal of Cancer
|June 1, 1995
Summary
Primary lymphomas causing epidural cord compression (ECC) are rare. Treatment combining surgery, steroids, radiotherapy, and chemotherapy led to significant neurological recovery in 81% of Non-Hodgkin
Area of Science:
- Oncology
- Neurology
- Pathology
Background:
- Primary lymphomas causing epidural cord compression (ECC) are a rare clinical entity, accounting for less than 3% of malignant lymphomas.
- Non-Hodgkin's Lymphoma (NHL), particularly the diffuse large cell type, is the most common histological subtype associated with ECC.
Purpose of the Study:
- To review 16 cases of primary Non-Hodgkin's Lymphoma (NHL) with epidural cord compression (ECC).
- To evaluate the treatment response and neurological recovery in patients with ECC due to primary lymphoma.
Main Methods:
- Retrospective review of 16 patients diagnosed with primary NHL and ECC between 1988-1990.
- Histological subclassification of NHL using the International Working Formulation.
- Assessment of disease spread and evaluation of treatment protocols including Laminectomy, high-dose steroids, local radiotherapy, and combination chemotherapy.
Main Results:
- All patients underwent Laminectomy for decompression.
- Patients with a longer duration of neurological deficit prior to treatment showed a poorer response.
- After 6 chemotherapy courses, 50% achieved complete neurological recovery (CR), 31% partial recovery (PR), and 19% no recovery (NR).
Conclusions:
- Multimodal treatment including chemotherapy, radiotherapy, and steroids can lead to significant neurological recovery in ECC from primary lymphoma.
- Early intervention may be crucial for better outcomes in patients with ECC.
- Non-Hodgkin's Lymphoma is a significant, albeit rare, cause of ECC requiring aggressive management.