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Non Hodgkin's lymphoma with metastasis to spine

Case contributed by Donald Luke Mathew
Diagnosis almost certain

Presentation

Known case of Non-Hodgkin’s lymphoma, post chemotherapy, now presenting with a severe backache.

Patient Data

Age: 55 years
Gender: Male

Multiple T1 hypointense, T2 and STIR hyperintense, heterogeneously enhancing marrow lesions throughout spine predominantly in the dorsal and lumbar spine, involving anterior and posterior elements, sacrum, and imaged pelvic bones in keeping with extensive skeletal metastasis.

A note of large volume retroperitoneal and mediastinal lymphadenopathy is also made.

Case Discussion

 A patient is known with Non-Hodgkin’s lymphoma (follicular lymphoma- Treated in 2014), transformation into diffuse large B-cell lymphoma (DLBCL), currently presents with gradually worsening backache.

MRI findings were discussed with the oncologist and were thought to be lymphoma related, although NHL spreading to spine is rare. A CSF cytology was suggested to assess meningeal metastasis.

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