title: [A case of intravascular malignant lymphomatosis presenting as slowly progressive paraplegia].
abstract: We present a case of a 62-year-old female was admitted with complaints of slowly developing paraplegia ascending from the distal portions, and a 7-month history of recto-urinary dysfunction. T2-weighted magnetic resonanse imaging (MRI) of the spinal cord showed hyperintense lesions in the thoracic and sacral cord. Multiple sclerosis was assumed, and steroid pulse therapy was therefore administered: this temporarily improved the symptoms and imaging findings. However, the symptoms recurred in 2 months. The patient died after ineffective steroid therapy. Large B-cell lymphoma cells were identified on bone marrow biopsy. Macroscopic neuropathology revealed neoplastic cells in the blood vessels of the cauda equina. Paraplegia appeared to have developed slowly and in a non-stepwise manner, since the cauda equina has been gradually invaded by intravascular malignant lymphomatosis.
authors.affiliation: Department of Neurology, Aichi M School of Medicine, 21 Karimata Yazako, Nagakute cho, Aichi gun, Aichi 480-1195, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Nakao
authors.forename: Mari
authors.initials: M
authors.lastname: Yoshida
authors.forename: Manabu
authors.initials: M
authors.lastname: Iwata
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Hashizume
authors.forename: Ko
authors.initials: K
authors.lastname: Sahashi
mesh_terms: D002420:Cauda Equina / Q000473:pathology; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010264:Paraplegia / Q000209:etiology*; D013116:Spinal Cord / Q000098:blood supply*; D019043:Vascular Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology