Diagnosis and management of intramedullary spinal cord lymphoma: A case illustration and review of literature

Background: Lymphoma of the spinal cord is rare and challenging to diagnose. They can be primary or metastasis. They often mimic inflammatory conditions and can have grave prognosis. Results: In this article, we report a 59-year-old male who presented with severe weakness and was found to have an isolated cervical spinal cord lesion. The suspicion of lymphoma was raised after the patient had marked improvement in symptoms and a dramatic reduction of lesion size on imaging after a short course of steroid administration. The diagnosis was made after peripheral blood cytometry and bone marrow biopsy, which confirmed Non-Hodgkin's lymphoma. A biopsy of the spinal cord lesion was not attempted. The patient showed significant improvement with complete resolution of the tumor after an aggressive regimen of chemotherapy. Conclusions: Based on our case and a systematic review of literature, we summarize the reported cases of the spinal cord lymphoma including its clinical presentation, diagnostic strategies, and treatment responses. Finally, we propose an algorithm for the diagnosis and management of this rare entity.