Abstract：
Primary malignant lymphoma confinement to the cauda equina is rare. Only 14 cases of primary malignant lymphoma in the cauda equina have been reported. In these cases, the clinical features were similar to those of lumbar spinal canal stenosis (LSCS). This report describes a case of diffuse large B-cell lymphoma of the cauda equina that was diagnosed after decompression surgery for LSCS. An 80-year-old man presented with gait disturbance due to progressive muscle weakness in the lower extremities over the previous two months. He was diagnosed with LSCS, and decompression surgery was performed. However, the muscle weakness worsened after surgery; therefore, he was referred to our department. Plain magnetic resonance imaging (MRI) revealed swelling of the cauda equina. It demonstrated marked homogenous enhancement by gadolinium-diethylenetriamine pentaacetic acid. 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) revealed diffuse accumulation of 18F-FDG in the cauda equina. These imaging findings were consistent with those of cauda equina lymphomas. To confirm the diagnosis, we performed an open biopsy of the cauda equina. Histological examination indicated diffuse large B-cell lymphoma. Considering the patient\'s age and activities of daily living, further treatment was not performed. The patient died four months after the first surgery. Rapid progression of muscle weakness, which cannot be prevented by decompression surgery, and swollen cauda equina on MRI may be signs of this disorder. Gadolinium-enhanced MRI, 18F-FDG PET, and histological investigation of the cauda equina should be performed for diagnosing primary malignant lymphoma of the cauda equina.
摘要：
原发性恶性淋巴瘤局限于马尾神经是罕见的。仅报道了14例马尾原发恶性淋巴瘤。在这些情况下,临床特征与腰椎管狭窄症（LSCS）相似。该报告描述了一例马尾神经弥漫性大B细胞淋巴瘤，该淋巴瘤是在LSCS减压手术后诊断的。一名80岁的男子在过去两个月中由于下肢进行性肌肉无力而出现步态障碍。他被诊断出患有LSCS,并进行了减压手术。然而,手术后肌肉无力恶化；因此，他被转介到我们部门。平扫磁共振成像（MRI）显示马尾神经肿胀。证明了钆-二亚乙基三胺五乙酸的显着均匀增强。18F-氟脱氧葡萄糖正电子发射断层扫描（18F-FDGPET）显示18F-FDG在马尾神经中弥漫性积累。这些影像学发现与马尾淋巴瘤的影像学发现一致。为了确认诊断，我们做了马尾神经的开放式活检.组织学检查提示弥漫性大B细胞淋巴瘤。考虑到患者的年龄和日常生活活动，未进行进一步治疗.患者在第一次手术后四个月死亡。肌肉无力的快速发展，这是减压手术无法预防的，MRI上马尾神经肿胀可能是这种疾病的征兆。钆增强MRI,18F-FDGPET,应进行马尾神经组织学检查以诊断马尾神经原发性恶性淋巴瘤。
