Primary Diffuse Large B-Cell Non-Hodgkin's Lymphoma of the Thoracic Spine Presented Initially as an Epigastric Pain

Abstract

Non-Hodgkin's lymphoma (NHL) compromises the vast majority of lymphomas and predominantly takes on the form of B-cell lymphomas. More specifically, 30% of all newly diagnosed cases of NHL in the United States (US) are of diffuse large B-cell lymphoma (DLBCL) type, making it the most prevalent form of NHL in the US. Arising from either nodal or extra-nodal lymphatic tissue origin, DLBCL is an aggressive tumor which is fatal if left untreated. Primary central nervous system lymphoma is rare; however, when diagnosed, it presents as a DLBCL in 90% of patients. Herein, we present an elderly male complaining initially of acute epigastric pain but soon afterward developed acute spinal cord compressive symptoms; subsequently, it was found to be caused by a primary DLBCL diagnosed in the thoracic spinal cord. This case report presents a rare condition with unexpected initial presentation, and we attempt to illustrate the importance of early detection and treatment of DLBCL in attaining more favorable prognostic and survival rates among patients. Written consent was obtained from the patient after reading a written summary of the case report. This consent was checked and approved from the Scientific Board of the University of Aleppo.

Keywords: Diffuse large B-cell lymphoma; epidural mass lesion; epigastric pain; non-Hodgkin's lymphoma; spinal tumor.