Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 22483
  Title Metastatic non-Hodgkin lymphoma presenting as low back pain and radiculopathy: A case report [case report]
URL http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437349/
Journal J Chiropr Med. 2012 Sep;11(3):202-206
Author(s)
Subject(s)
Peer Review Yes
Publication Type Case Report
Abstract/Notes

Objective: The purpose of this case report is to describe a case of metastatic non-Hodgkin lymphoma in the lumbar spine presenting as lumbar radiculopathy.

Clinical Features: A 46-year-old man sought care from his doctor of chiropractic for low back pain and right leg radiculopathy. The patient was referred for a magnetic resonance imaging (MRI) scan to evaluate for a suspected disk herniation. The MRI scan revealed 2 lumbar pathologic compression fractures with cauda equina compression, and MRI short tau inversion recovery (STIR) sagittal image of the lumbar spine showed high signal in T12 and S2.

Intervention and Outcome: The patient was referred for an immediate consultation with his medical physician with the preliminary diagnosis of metastatic bone lesions or primary bone lesions of unknown etiology. The patient underwent bone biopsy, computed tomography, and positron emission tomography scanning and was diagnosed with small cell non-Hodgkin lymphoma with osseous metastasis. The patient underwent chemo- and radiation therapy, and the lymphoma is now in remission 18 months later.

Conclusion: This case describes the presentation of metastatic non-Hodgkin lymphoma as a possible contributing cause in a patient presenting with lumbar radiculopathy, a common musculoskeletal condition. As well, this case highlights the importance of STIR sequences as part of a routine lumbar spine MRI examination. Without the STIR sequences, the additional deposits in T12 and S1 would not have been readily appreciated. Although metastatic non-Hodgkin lymphoma of the spine is rare, it should be remembered in the differential diagnoses.

This abstract is reproduced with the permission of the publisher; click on the above link for free full text.


 

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