title: Aggressive plasmablastic lymphoma of the thoracic spine presenting as acute spinal cord compression in a case of asymptomatic undiagnosed human immunodeficiency virus infection.
abstract: BACKGROUND
  Plasmablastic lymphoma (PBL) is a rare aggressive variant of diffuse large B-cell lymphoma.
  
  
  OBJECTIVE
  We describe a rare case of an aggressive PBL presenting as acute spinal cord compression requiring thoracic decompression and fusion, in a case of previously undiagnosed human immunodeficiency virus (HIV) infection.
  
  
  METHODS
  A case report.
  
  
  METHODS
  A patient with PBL of the thoracic spine.
  
  
  METHODS
  Preoperative magnetic resonance imaging, pathologic findings from the operative specimen, and serum HIV testing confirmed the diagnosis.
  
  
  METHODS
  We present the case of a 33-year-old Caucasian woman with a 10-day history of thoracic back pain and a 1-day history of sudden-onset bilateral lower limb weakness and paresthesia from below the level of the umbilicus (American Spinal Injury Association [ASIA] Grade C). Magnetic resonance imaging demonstrated an extradural mass extending from T3 to T6 within the left posterior canal, resulting in significant cord compression. A complete debulking of the tumor mass and an instrumented posterior thoracic fusion was performed.
  
  
  RESULTS
  Histopathologic examination of the specimen revealed tumor cells of PBL, and subsequent HIV testing was positive. She was treated with intravenous and intrathecal chemotherapy to prevent recurrence. Her lower limb neurologic status improved to ASIA Grade D over the subsequent 2 weeks.
  
  
  CONCLUSIONS
  We report the case of an aggressive PBL presenting as acute spinal cord compression requiring urgent surgical intervention, on a background of undiagnosed HIV infection.
authors.affiliation: National Spinal Injuries Unit, Department of Trauma & Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland. Electronic address: ellyharris@gmail.com.
authors.forename: Ella
authors.initials: E
authors.lastname: Harris
authors.affiliation: National Spinal Injuries Unit, Department of Trauma & Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland.
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Butler
authors.affiliation: National Spinal Injuries Unit, Department of Trauma & Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland.
authors.forename: Noelle
authors.initials: N
authors.lastname: Cassidy
mesh_terms: D000328:Adult; D001416:Back Pain / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000473:pathology; D006801:Humans; D007796:Laminectomy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications* / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D013117:Spinal Cord Compression / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D013123:Spinal Fusion; D013125:Spinal Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Acquired immunodeficiency syndrome (AIDS); Human immunodeficiency virus (HIV); Non-Hodgkin lymphoma (NHL); Plasmablastic lymphoma (PBL); Spinal cord; Spinal cord compression