title: Extradural malignant lymphoma associated with spinal cord compression.
abstract: Cord compression was noted in 26 patients with extradural malignant lymphoma. There were 19 cases of nonHodgkin's lymphoma and seven cases of Hodgkin's disease. Eighteen cases of non-Hodgkin's lymphoma had intermediate or high grade malignancy types according to the Working Formulation Lymphoma Classification. These patients represented 28% of all extradural malignant tumours seen at the Royal Adelaide Hospital (RAH) and 2.5% of all patients with malignant lymphoma, during an 11 year period. The patients were classified in three presenting groups: Group A, six patients with primary extranodal extradural lymphoma; Group B, nine patients with both extradural lymphoma and disseminated disease at initial presentation; and Group C, 11 patients who developed extradural lymphoma during the course of established disease. Only classification by groups appeared to affect survival time. Group A had the most favourable prognosis, with a 5 year survival of 83%. Five of the Group A patients had a relapse of lymphoma; four at distant sites and one in the retroperitoneum. Laminectomy was essential to provide a diagnosis in Group A patients. The most useful warning symptom of impending spinal cord compression was back and/or radicular pain, which preceded neurological deficit either by days or by up to 5 years. Plain spinal X-rays were abnormal in 64% of cases, emphasizing the value of this simple procedure.
authors.affiliation: Gribbles Pathology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: K S
authors.initials: KS
authors.lastname: Crowley
authors.forename: J
authors.initials: J
authors.lastname: Miliauskas
authors.forename: J B
authors.initials: JB
authors.lastname: North
authors.forename: A
authors.initials: A
authors.lastname: Esterman
authors.forename: A S
authors.initials: AS
authors.lastname: Leong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006689:Hodgkin Disease / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D006801:Humans; D015994:Incidence; D007796:Laminectomy; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult