T-cell lymphoma mimicking schwannoma of a cervical nerve root

Neurosurg Rev. 2009 Jan;32(1):117-21; discussion 121. doi: 10.1007/s10143-008-0169-x. Epub 2008 Sep 20.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biopsy
  • 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
  • Neurilemmoma / pathology*
  • Neurilemmoma / surgery
  • 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

Substances

  • CD3 Complex
  • Leukocyte Common Antigens