We present a 68-year-old man suffering from transverse myelopathy since May 2010. The spinal cord MRI showed a T2-hyperintense lesion invading the Th5 level spinal cord. Although the patient transiently responded to steroid-pulse therapy, his neurological symptoms degenerated three months after wards. On admission, he had an apparent hepatosplenomegaly, but no lymphadenopathy. A laboratory examination revealed bicytopenia and increased levels of LDH and soluble IL-2 receptors. Histological analysis of a skin biopsy specimen demonstrated proliferation of large atypical lymphoid cells positive for CD20 and CD79a in the small capillaries, leading to our diagnosis of intravascular large B-cell lymphoma (IVLBCL). Thus, the patient's progressive myelopathy was probably caused by IVLBCL invasion. The patient responded well to Rituximab-combined CHOP therapy (R-CHOP), and his neurological symptoms improved immediately. A spinal cord MRI showed the disappearance of the abnormal signal after two courses of R-CHOP. IVLBCL often presents with neurological manifestations, including transverse myelopathy.
|ジャーナル||Japanese Journal of Cancer and Chemotherapy|
|出版ステータス||Published - 2011 11|
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