J Korean Neurosurg Soc.  2012 Dec;52(6):564-566. 10.3340/jkns.2012.52.6.564.

Solitary Lymphoblastic Lymphoma of the Thoracic Spine

• Park DA
• Park SG
• Kim SW

• KMID: 1426270
• DOI: http://doi.org/10.3340/jkns.2012.52.6.564

Abstract

Non-Hodgkin's lymphoma rarely originates from bone, and even more infrequently from a vertebral body. Lymphoblastic lymphoma is a rare type of non-Hodgkin's lymphoma, and results from an abnormality in adaptive immune cells. A 27-year-old man presented with a two-month history of night sweats, weight loss, and severe back pain. Radiological studies demonstrated an osteolytic lesion compressing the subarachnoid space at the T11 level. Posterolateral fusion with decompression was performed and a pathologic examination confirmed lymphoblastic lymphoma of the B-cell precursor type. To our knowledge, this is the first report of solitary lymphoblastic lymphoma from B-cell precursors in of the thoracic spine. Herein, we discuss the presenting symptoms and the management of this rare case of lymphoblastic lymphoma.

Keyword

Lymphoblastic lymphoma; Spine

MeSH Terms

B-Lymphocytes
Back Pain
Decompression
Lymphoma, Non-Hodgkin
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Spine
Subarachnoid Space
Sweat
Weight Loss

Figure

• 

  Fig. 1 Computed tomography scans of the patient. Computed tomography scans show lytic destruction of vertebral body and right pedicle at T11.

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  Fig. 2 Magnetic resonance images of the patient. T2-weighted sagittal magnetic resonance images reveal abnormally high signal intensity in the T11 vertebral body and spinal cord compression by soft tissue extension.

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  Fig. 3 Radionuclide bone scintigraphy and positron emission tomography. A : Radionuclide bone scintigraphy using MDP 99mTechnetium shows intense, uptake in the T11 vertebral body without systemic involvement. B : Positron emission tomography clearly depicts the hypermetabolic lesion at T11.

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  Fig. 4 Histopathological examination of the patient. A : On hematoxylin and eosin staining, biopsy material shows malignant small round cells infiltrating bone and soft tissue in low power field. B : In high power field, malignant small cells with scant cytoplasm observed fine chromatin, convoluted nuclear membrances. C and D : Immunohistochemical studies show positivity in CD10 (C) and CD99 (D). The tumor was compatible with malignant lymphoma, precursor B cell lineage.

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