Cauda equina-conus medullaris syndrome as an isolated presenting symptom of intravascular large B-cell lymphoma: Case report and review of the literature
Journal
Neurology Asia
Journal Volume
19
Journal Issue
2
Pages
219-225
Date Issued
2014
Author(s)
Abstract
Intravascular large B-cell lymphoma (IVLBCL) is a rare non-Hodgkin lymphoma with variable clinical manifestations. Although neurological symptoms are common in patients with IVLBCL, isolated cauda equina-conus medullaris syndrome is rarely reported. We herein report a case of IVLBCL whose initial presentation was cauda equina-conus medullaris syndrome with neither dermatological nor hematological manifestations. A 54-year-old man without known immune-compromised state presented with progressive ascending numbness and weakness of bilateral legs and urine incontinence for 2 months. Lumbar-sacral magnetic resonance images showed gadolinium-enhanced conus medullaris and cauda equina nerve roots. Cerebrospinal fluid analysis revealed lymphocyte predominant pleocytosis and elevated protein level without malignant cells. Focal seizure and mental status changes followed several weeks later. Brain biopsy led to the diagnosis of IVLBCL. Conclusions: IVLBCL should be included in the differential diagnosis of patients with isolated cauda equina-conus medullaris syndrome. A survey of previously published cases in the literature also showed that early initiation of chemotherapy has better outcome.
SDGs
Other Subjects
CD20 antigen; CD79a antigen; cytarabine; gadolinium; interferon regulatory factor 4; lactate dehydrogenase; methotrexate; protein; rituximab; adult; article; brain biopsy; cancer chemotherapy; case report; cauda equina conus medullaris syndrome; cauda equina syndrome; cause of death; cerebrospinal fluid analysis; consciousness; contrast enhancement; drug megadose; flaccid paralysis; follow up; human; human tissue; hyperlipidemia; hypertension; kidney polycystic disease; lactate dehydrogenase blood level; large cell lymphoma; leg pain; limb weakness; male; middle aged; muscle strength; neurologic examination; nuclear magnetic resonance imaging; pancytopenia; paresthesia; pleocytosis; seizure; sensory dysfunction; sepsis; symptom; urine incontinence; white matter lesion
Publisher
ASEAN Neurological Association
Type
journal article