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Case Reports: Rare disease
Lumbar radiculopathy secondary to primary spinal dural diffuse large B-cell lymphoma
  1. Christopher Alan Brooks1,
  2. John David Kehoe1,
  3. Neal Kerr1,
  4. Fouzia Ziad2 and
  5. Sami Raunio1
  1. 1Neurosurgery, Waikato Hospital, Hamilton, Waikato, New Zealand
  2. 2Pathology, Waikato Hospital, Hamilton, Waikato, New Zealand
  1. Correspondence to Dr Christopher Alan Brooks; brooks.christopher.alan{at}gmail.com

Abstract

Lymphoma of a dural genesis is a distinct variant of primary central nervous system lymphoma and is rare. It putatively has a more benign clinical course. Cranial primary dural lymphoma is more often marginal zone B-cell lymphoma, whereas spinal primary dural lymphoma is most commonly diffuse large B-cell lymphoma.

We report a male patient who presented with subacute progressive radiculopathy due to a compressive infiltrative lumbosacral spinal lesion. This was determined to be primary dural diffuse large B-cell lymphoma. The radiology, therapeutic considerations and differentiating biological characteristics of primary dural lymphoma, differ from other primary central nervous system lymphomas.

Primary dural lymphoma is under-represented in the medical literature. It has unique clinical characteristics. The optimal treatment algorithm remains undefined, but there is some evidence suggesting a benefit of surgical cytoreductive therapy in the first instance, and low-dose radiotherapy may be an effective adjuvant therapy in addition to chemotherapeutic and immunotherapeutic agents.

  • neurooncology
  • neurosurgery
  • haematology (incl blood transfusion)

http://dx.doi.org/10.1136/bcr-2022-254093

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    Footnotes

    • Contributors CAB wrote and edited the manuscript and produced the figures. JDK performed the literature search and wrote the abstract. NK assisted with the conception of the article. FZ provided the histopathological images. SR supervised the project.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.