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Ponzo G, Umana GE, Valastro M, et al. Cervical radiculopathy as first presentation of CD3-positive diffuse large B-cell lymphoma of the cervico-thoracic junction. Br J Neurosurg. 2020;1-4doi: 10.1080/02688697.2020.1828278.
Ponzo, G., Umana, G. E., Valastro, M., Giuffrida, M., Tranchina, M. G., Nicoletti, G. F., & Scalia, G. (2020). Cervical radiculopathy as first presentation of CD3-positive diffuse large B-cell lymphoma of the cervico-thoracic junction. British journal of neurosurgery, 1-4. https://doi.org/10.1080/02688697.2020.1828278
Ponzo, Giancarlo, et al. "Cervical radiculopathy as first presentation of CD3-positive diffuse large B-cell lymphoma of the cervico-thoracic junction." British journal of neurosurgery vol. (2020): 1-4. doi: https://doi.org/10.1080/02688697.2020.1828278
Ponzo G, Umana GE, Valastro M, Giuffrida M, Tranchina MG, Nicoletti GF, Scalia G. Cervical radiculopathy as first presentation of CD3-positive diffuse large B-cell lymphoma of the cervico-thoracic junction. Br J Neurosurg. 2020 Oct 05;1-4. doi: 10.1080/02688697.2020.1828278. Epub 2020 Oct 05. PMID: 33012208.
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Br J Neurosurg. 2020 Oct 05;1-4. doi: 10.1080/02688697.2020.1828278. Epub 2020 Oct 05.

Cervical radiculopathy as first presentation of CD3-positive diffuse large B-cell lymphoma of the cervico-thoracic junction.

British journal of neurosurgery

Giancarlo Ponzo, Giuseppe Emmanuele Umana, Maurizio Valastro, Massimiliano Giuffrida, Maria Grazia Tranchina, Giovanni Federico Nicoletti, Gianluca Scalia

Affiliations

  1. Neurosurgery Unit, Highly Specialized Hospital and of National Importance "Garibaldi", Catania, Italy.
  2. Department of Neurosurgery, Cannizzaro Hospital, Trauma Center, Gamma Knife Center, Catania, Italy.
  3. Radiodiagnostic Unit, Highly Specialized Hospital of National Importance "Garibaldi", Catania, Italy.
  4. Department of Pathological Anatomy, Cannizzaro Hospital, Catania, Italy.

PMID: 33012208 DOI: 10.1080/02688697.2020.1828278

Abstract

BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) in rare cases can presents an unusual expression of CD3 T-cell specific antigen. We report the first case of a CD3-positive DLBCL of the cervico-thoracic junction presenting with persistent cervical radiculopathy.

CASE PRESENTATION: A 74-years-old male patient presented a severe and persistent right C8 radiculopathy associated with right-sided neck pain, progressive numbness and weakness of the right arm. The symptoms prominent during the night interfering with sleep and were resistant to anti-inflammatory drugs and cervical orthosis. Spine MRI showed a solid hypointense lesion on T2-weighted images and hyperintense on STIR sequences involving the epidural space at C7, T1 and T2. The patient underwent a C7-T1 decompressive laminectomy and left T2 hemilaminectomy with resection of the epidural tissue resulting in subtotal removal. Histology showed a DLBCL germinal center B-cell lymphoma with expression of CD3 T-cell specific antigen. Then the patient underwent adjuvant radiotherapy and chemotherapy consisting of R-CHOP protocol. At last follow-up (2 years) the patient is still in good clinical status (KPS = 80) with almost complete recovery of the cervical radiculopathy.

CONCLUSIONS: To our knowledge this is the first case of DLBLC GCB-like CD3 positive to present with radiculopathy.

Keywords: Non-Hodgkin lymphoma; cervico-thoracic junction; epidural space; radiculopathy; spine

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