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 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.
Wachter
D
D
Department of Neurosurgery, Justus Liebig University, Giessen, Germany. dorothee.wachter@neuro.med.uni-giessen.de
Tschischka
S
S
Huegens-Penzel
M
M
Kuchelmeister
K
K
Bohle
R M
RM
Böker
D-K
DK
Nestler
U
U
D000368:Aged; D001706:Biopsy; D017252:CD3 Complex; D002574:Cervical Vertebrae; D003937:Diagnosis, Differential; D005727:Ganglia, Spinal / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D017493:Leukocyte Common Antigens / Q000276:immunology; D016399:Lymphoma, T-Cell / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D009442:Neurilemmoma / Q000473:pathology* / Q000601:surgery; D010524:Peripheral Nervous System Neoplasms / Q000473:pathology* / Q000601:surgery; D011843:Radiculopathy / Q000209:etiology / Q000601:surgery; D013126:Spinal Nerve Roots / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed
D017252:CD3 Complex; D017493:Leukocyte Common Antigens