Lymphoma with Intraspinal Extramedullary Involvement as Initial Presentation

Szu-Jung Chen, Na-Na Chung, Louis Tak Lui, Wei-Chung Hsu, Lai-Lei Ting

Research output: Contribution to journalArticle

Abstract

Purpose: To review the treatment results of lymphoma with initial presentation of spinal cord or cauda equina compression.Materials and Methods: Lymphoma with cord or cauda equina compression as initial presentation were seen in 9 patients in our hospital between 1977 to 1996. Among them, six patients presented with stage IE primary spinal epidurl involvement, whereas the others has stage ⅡE, ⅢE and ⅣE disease (1 patient each). Except for one Hodgkin's lymphoma and one lymphosarcoma, all of the other patients were non-Hodgkin's lymphoma with unfavorable histologic grading, mostly were the intermediate grade classification according to the Warking Formulation. After decompression surgery, the subsequent treatments of these patients were radiotherapy (2 patients), chemotherapy (1 patient), and combination of both treatment modalities (6 patients).Results: A prodromal phase of local back pain occurred in all patients, with duration from 1 to 10 months, followed by a second phase of rapidly progressive signs of cord compression. After treatment, 5 patients achieved complete remission: among with, one died of chemotherapy complication, one died of intercurrent disease, one had distant metastasis, and only 2 patients remained disease free. The other 4 patients who got partial remission were all dead of this disease.Conclusion: Lymphoma with spinal epidural or intradural involvement at initial presentation is an aggressive disease. An intensive treatment combination with irradiation, chemotherapy, and surgery, is suggested in order to achieve good local control and longterm survival.
Original languageEnglish
Pages (from-to)179-186
Number of pages8
Journal放射治療與腫瘤學
Volume5
Issue number3
DOIs
Publication statusPublished - 1998
Externally publishedYes

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Lymphoma
Cauda Equina
Drug Therapy
Non-Hodgkin's Lymphoma
Therapeutics
Back Pain
Decompression
Hodgkin Disease
Spinal Cord
Radiotherapy
Neoplasm Metastasis
Survival

Keywords

  • Decompression surgery
  • Epidural lymphoma
  • Intradural lymphoma

Cite this

Lymphoma with Intraspinal Extramedullary Involvement as Initial Presentation. / Chen, Szu-Jung ; Chung, Na-Na; Lui, Louis Tak; Hsu, Wei-Chung; Ting, Lai-Lei.

In: 放射治療與腫瘤學, Vol. 5, No. 3, 1998, p. 179-186.

Research output: Contribution to journalArticle

Chen, Szu-Jung ; Chung, Na-Na ; Lui, Louis Tak ; Hsu, Wei-Chung ; Ting, Lai-Lei. / Lymphoma with Intraspinal Extramedullary Involvement as Initial Presentation. In: 放射治療與腫瘤學. 1998 ; Vol. 5, No. 3. pp. 179-186.
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N2 - Purpose: To review the treatment results of lymphoma with initial presentation of spinal cord or cauda equina compression.Materials and Methods: Lymphoma with cord or cauda equina compression as initial presentation were seen in 9 patients in our hospital between 1977 to 1996. Among them, six patients presented with stage IE primary spinal epidurl involvement, whereas the others has stage ⅡE, ⅢE and ⅣE disease (1 patient each). Except for one Hodgkin's lymphoma and one lymphosarcoma, all of the other patients were non-Hodgkin's lymphoma with unfavorable histologic grading, mostly were the intermediate grade classification according to the Warking Formulation. After decompression surgery, the subsequent treatments of these patients were radiotherapy (2 patients), chemotherapy (1 patient), and combination of both treatment modalities (6 patients).Results: A prodromal phase of local back pain occurred in all patients, with duration from 1 to 10 months, followed by a second phase of rapidly progressive signs of cord compression. After treatment, 5 patients achieved complete remission: among with, one died of chemotherapy complication, one died of intercurrent disease, one had distant metastasis, and only 2 patients remained disease free. The other 4 patients who got partial remission were all dead of this disease.Conclusion: Lymphoma with spinal epidural or intradural involvement at initial presentation is an aggressive disease. An intensive treatment combination with irradiation, chemotherapy, and surgery, is suggested in order to achieve good local control and longterm survival.

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