T-cell lymphoma mimicking schwannoma of a cervical nerve root

T-cell lymphoblastic lymphoma is a rare form of non-Hodgkin lymphoma, which shows preponderance for young men. Most common symptoms are painless swelling of lymph nodes, accompanied by B symptoms and large mediastinal masses. Most often, an involvement of the nervous system is due to paraneoplastic...

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Bibliographic Details
Published in:Neurosurgical review 2009, Vol.32 (1), p.117-121
Main Authors: Wachter, D., Tschischka, S., Huegens-Penzel, M., Kuchelmeister, K., Bohle, R. M., Böker, D.-K., Nestler, U.
Format: Article
Language:English
Subjects:
Aged
Biopsy
Case Report
CD3 Complex
Cervical Vertebrae
Diagnosis, Differential
Ganglia, Spinal - pathology
Humans
Immunohistochemistry
Leukocyte Common Antigens - immunology
Lymphoma, T-Cell - pathology
Lymphoma, T-Cell - surgery
Magnetic Resonance Imaging
Male
Medicine
Medicine & Public Health
Neurilemmoma - pathology
Neurilemmoma - surgery
Neurosurgery
Peripheral Nervous System Neoplasms - pathology
Peripheral Nervous System Neoplasms - surgery
Radiculopathy - etiology
Radiculopathy - surgery
Spinal Nerve Roots - pathology
Spinal Nerve Roots - surgery
Tomography, X-Ray Computed
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Summary:T-cell lymphoblastic lymphoma is a rare form of non-Hodgkin lymphoma, which shows preponderance for young men. Most common symptoms are painless swelling of lymph nodes, accompanied by B symptoms and large mediastinal masses. Most often, an involvement of the nervous system is due to paraneoplastic symptoms or side effects of treatment. In a literature research, we could not find a case with affection of a cervical nerve root as the first symptom for T-cell lymphoblastic lymphoma. A 39-year-old man presented with right-sided C8 radiculopathy, including pareses and paresthesia. Since the magnetic resonance image disclosed a right-sided mass lesion in the region of the neuroforamen C8, compressing the corresponding nerve root, a schwannoma was suspected. The tumor was removed using a dorsal approach. Neuropathological examination revealed the diagnosis of T-cell lymphoblastic lymphoma. The patient underwent diagnostic staging and received further treatment. He experienced a very grim course and succumbed to his disease 12 months after surgery. T-cell lymphoblastic lymphoma is a rare disease, and tropism of lymphoma cells to neural structures is seldom encountered. However, the presence of radiculopathy, together with signs, referring to B symptoms, should prompt the physician to consider this coincidence in the differential diagnosis of schwannoma.
ISSN:0344-5607
1437-2320
DOI:10.1007/s10143-008-0169-x