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Spinal cord infarct as the initial clinical presentation of intravascular malignant lymphomatosis

He Liu1, Izumi Koyanagi, Hideki Chiba

  • 1Department of Neurosurgery, Sapporo Medical University School of Medicine, South-1st, West-16th, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan. drliuhe@hotmail.com

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|February 10, 2009
PubMed

Insights

Intravascular malignant lymphomatosis (IML) is a rare disorder causing lymphoma cell proliferation within blood vessels. This study highlights IML as a critical differential diagnosis for unexplained progressive paraparesis, often missed before autopsy.

Area of Science:

  • Hematology
  • Neurology
  • Oncology

Background:

  • Intravascular malignant lymphomatosis (IML) is an exceptionally rare lymphoproliferative disorder.
  • It is defined by the proliferation of lymphoma cells within vascular lumens.

Observation:

  • A case of a 78-year-old man presenting with spinal cord infarct at T11/12 is detailed.
  • Diagnosis was delayed, only confirmed post-mortem despite initial biopsies.
  • A review identified 19 IML patients with initial spinal cord symptoms.

Findings:

  • IML can manifest initially with spinal cord symptoms, mimicking other neurological conditions.
  • Clinical and radiological features of IML presenting with neurological deficits were analyzed.
  • Limitations of standard biopsy procedures in diagnosing IML were considered.

Implications:

  • IML should be considered in the differential diagnosis of progressive paraparesis of unknown origin.
  • Early recognition of IML can improve patient outcomes.
  • Further research into diagnostic methods for IML is warranted.

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