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BMJ Case Reports 2009; doi:10.1136/bcr.03.2009.1657
  • Reminder of important clinical lesson

Spinal cord compression: to biopsy, or not to biopsy?

  1. Gulraj Matharu1,
  2. Daisy Wilson1,
  3. Vaiyapuri Sumathi2,
  4. Tehreem Butt3
  1. 1
    University Hospital Birmingham NHS Trust, Medicine, Selly Oak Hospital, Raddlebarn Road, Birmingham B29 6JD, UK
  2. 2
    University Hospital Birmingham NHS Trust, Pathology, Selly Oak Hospital, Raddlebarn Road, Birmingham B29 6JD, UK
  3. 3
    University of Birmingham, Clinical Pharmacology, Clinical Investigation Unit, Queen Elizabeth Hospital, Birmingham B15 2TH, UK
  1. Tehreem Butt, t.f.butt{at}bham.ac.uk
  • Published 20 August 2009

Summary

A patient presenting with acute spinal cord compression initially thought to be secondary to metastatic cancer based on magnetic resonance imaging alone is described. No primary tumour was identified on further imaging, and although deemed to be technically very difficult, surgical decompression was postponed in favour of obtaining a histological diagnosis. Histology confirmed a low grade non-Hodgkin’s lymphoma, a diagnosis which would not have been considered had a biopsy not been undertaken. The correct curative treatment was subsequently initiated, and the patient responded well to localised radiotherapy and intrathecal methotrexate.

Footnotes

  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication

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