Dergiler / Turkish Journal of Hematology / 2016 / Cilt: 33 - Sayı: 2
İlk Tanı Sırasında Spinal Kitle ile Prezente olan Prekürsör B-Hücreli Lenfoblastik Lenfoma
- Sayfa
- 92–93
- DOI
- —
Özet
An 18-year-old male presented to the emergency departmentof our hospital with complaints of bilateral leg numbness andweakness since about a month. Magnetic resonance imagingof the spine revealed an extramedullary extradural mass atthe T9-T11 level causing marked spinal cord compression.Emergent surgery was performed. An epidural mass wasseen after laminectomy and partially removed. Microscopicexamination showed a diffuse infiltration of small- tomedium-sized lymphoid cells with irregular nuclei, dispersednuclear chromatin, prominent nucleoli, and scant cytoplasm inadipose tissue (Figure 1). Immunohistochemical examinationdemonstrated that tumor cells stained positively for TdT, CD34,CD10, CD20, CD79a, Pax-5, CD45, and Bcl-2 (Figure 2). Ki-67showed immunoreactivity of 80% of tumor cells. Bone marrowand blood involvements were not detected. These findings led usto the diagnosis of precursor B-cell lymphoblastic lymphoma. Hewas given combination chemotherapy of R-HCVAD (rituximab,cyclophosphamide, vincristine, doxorubicin, dexamethasone,cytarabine, mesna, methotrexate). After the second dose ofchemotherapy, complete response was achieved as assessed bypositron emission tomography/computed tomography scan.The spinal cord is an extremely rare initial site of involvementfor B-cell lymphoblastic lymphoma. To our knowledge, there areonly 3 reported cases in the English literature (Table 1) [1,2,3]. Lymphoblastic lymphoma should be included in the differentialdiagnosis of spinal masses.AcknowledgmentPresented at the 25th National Congress of Pathology 2015,Bursa, Turkey
Abstract
An 18-year-old male presented to the emergency departmentof our hospital with complaints of bilateral leg numbness andweakness since about a month. Magnetic resonance imagingof the spine revealed an extramedullary extradural mass atthe T9-T11 level causing marked spinal cord compression.Emergent surgery was performed. An epidural mass wasseen after laminectomy and partially removed. Microscopicexamination showed a diffuse infiltration of small- tomedium-sized lymphoid cells with irregular nuclei, dispersednuclear chromatin, prominent nucleoli, and scant cytoplasm inadipose tissue (Figure 1). Immunohistochemical examinationdemonstrated that tumor cells stained positively for TdT, CD34,CD10, CD20, CD79a, Pax-5, CD45, and Bcl-2 (Figure 2). Ki-67showed immunoreactivity of 80% of tumor cells. Bone marrowand blood involvements were not detected. These findings led usto the diagnosis of precursor B-cell lymphoblastic lymphoma. Hewas given combination chemotherapy of R-HCVAD (rituximab,cyclophosphamide, vincristine, doxorubicin, dexamethasone,cytarabine, mesna, methotrexate). After the second dose ofchemotherapy, complete response was achieved as assessed bypositron emission tomography/computed tomography scan.The spinal cord is an extremely rare initial site of involvementfor B-cell lymphoblastic lymphoma. To our knowledge, there areonly 3 reported cases in the English literature (Table 1) [1,2,3]. Lymphoblastic lymphoma should be included in the differentialdiagnosis of spinal masses.AcknowledgmentPresented at the 25th National Congress of Pathology 2015,Bursa, Turkey