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• W2041152123 abstract "There is a paucity of reports concerning lymphomatous involvement of the spinal canal. Review of the literature leaves one confused as to the incidence of primary central nervous system involvement by lymphoma, its best management, and the results to be expected from it. In an attempt to clarify these points, we have reviewed the experience of the Division of Radiotherapy of the Columbia-Presbyterian Medical Center and New York Neurological Institute with 53 histologically proved cases of spinal canal lymphoma. This discussion is limited to involvement of the spinal canal; intracranial and peripheral nerve involvement is excluded. By the term lymphoma, we include Hodgkin's disease, lymphosarcoma, and reticulumcell sarcoma, but exclude leukemia and myeloma. Fifty-eight patients with lymphoma of the spinal canal were registered between January 1935 and December 1964. The hospital charts were not available for review in 5 cases, leaving 53 for analysis. Histologic proof of epidural disease was obtained in 48. In 5 the histologic diagnosis was made from biopsy of another site. In addition, the clinical course, roentgenographic and laboratory data, and treatment response were consistent with spinal canal lymphoma. The sex ratio was 34 males to 19 females, and the age at presentation ranged from nine to seventy-one years, the mean age being forty-three and a half years (Fig. 1). Local or radiating pain was experienced by all patients and was the most frequent initial symptom. Other initial symptoms were : paraparesis (6 cases) , bowel disturbance (1 case), nonspecific respiratory symptoms (6 cases), and pruritus (1 case). Forty-seven patients had a sensory deficit on admission; 42 had motor weakness or paralysis. Sphincteric disturbance was present in 26. The duration of symptoms prior to hospitalization averaged six weeks, with 7 patients noting symptoms for less than two weeks and 5 for more than one year. In contrast with other series, spinal canal involvement was the first manifestation of lymphoma in 45 patients (7). No histological type demonstrated a predilection for a particular area of the spinal canal (Fig. 2). Roentgenographic studies showed adjacent bony involvement in 29 patients. A paravertebral soft-tissue mass was noted radiographically or at the time of surgery in 30 cases. In 32 patients myelography was performed; in all the findings were abnormal and showed an extradural mass constricting the intradural space. Laboratory studies proved of little diagnostic aid except that the cerebrospinal fluid protein value was elevated in all 47 patients in whom the test was performed. The mode of treatment, clinical response, and survival in 51 cases are shown in Figure 3. Thirty-nine patients (77 per cent) benefited from therapy. Although the therapeutic result was generally inversely proportional to delay between onset of symptoms and institution of treatment, several patients made an excellent recovery despite sphincteric disturbance for periods of several days." @default.
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• W2041152123 date "1967-08-01" @default.
• W2041152123 modified "2023-10-18" @default.
• W2041152123 title "Radiation Therapy for Lymphoma of the Spinal Canal" @default.
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• W2041152123 doi "https://doi.org/10.1148/89.2.313" @default.
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