title: Primary NK/T-cell lymphoma of the cauda equina: a case report and literature review.
abstract: METHODS
  A case report with a review of the literature.
  
  
  OBJECTIVE
  To describe an unusual case of primary lymphoma of the cauda equina and provide a review of the literature of this condition.
  
  
  BACKGROUND
  Primary lymphoma of the cauda equina is extremely rare, and has been reported in 8 cases previously. This report is the first to describe a case of primary nasal type NK/T-cell lymphoma of the cauda equina.
  
  
  METHODS
  We report the case of a 67-year-old man presenting the symptoms of cauda equina syndrome caused by primary lymphoma of the cauda equina.
  
  
  RESULTS
  After laminectomy and removal of the tumor, the patient recovered from the symptoms of cauda equina syndrome except for bladder and bowel dysfunction. Further investigations including immunohistochemical stains made a diagnosis of primary nasal type NK/T-cell lymphoma of the cauda equina, and the patient received radiotherapy to the lumbosacral area. Brain metastasis was detected 8 months after surgery, and the patient died 14 months after his initial clinical presentation despite additional treatments including whole-brain radiotherapy and oral chemotherapy.
  
  
  CONCLUSIONS
  Although primary lymphoma of the cauda equina is extremely rare, the prognosis of this condition is thought to be poor. Early definitive diagnosis with examination of the cerebrospinal fluid followed by combined treatment with radiotherapy and high-dose methotrexate should be considered.
authors.affiliation: Department of Orthopaedic Surgery, Izumi Municipal Hospital, and Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan. m1908130@msic.med.osaka-cu.ac.jp
authors.forename: Masahiro
authors.initials: M
authors.lastname: Morita
authors.forename: Masahiko
authors.initials: M
authors.lastname: Osawa
authors.forename: Hirotsune
authors.initials: H
authors.lastname: Naruse
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000556:secondary; D019299:Decompression, Surgical; D017809:Fatal Outcome; D006801:Humans; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D054391:Lymphoma, Extranodal NK-T-Cell / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D009192:Myelography; D009362:Neoplasm Metastasis / Q000473:pathology / Q000503:physiopathology; D011128:Polyradiculopathy / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D011878:Radiotherapy; D012585:Sciatica / Q000209:etiology; D013115:Spinal Canal / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D013120:Spinal Cord Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D013126:Spinal Nerve Roots / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000209:etiology