Title : Mature B-cell lymphoma with acute myelitis as the first presentation: A case report and literature review
Abstract:
Background: Lymphomas are malignant neoplasms of the immune system, originating in lymphoid organs and having the potential to affect the central nervous system. Notably, lymphomas presenting initially as acute myelitis are extremely rare. Most of these cases exhibit symptoms of spinal - cord impairment, mainly due to the lack of specificity in their clinical manifestations. This leads to a very high rate of early misdiagnosis and a poor prognosis. Herein, we present a case of mature B - cell lymphoma with acute myelitis as the initial manifestation and conduct a review of the relevant literature.
Case Presentation: In this study, we report on a 70 - year - old male patient who presented with bilateral lower - extremity weakness, bowel and bladder dysfunction, and recurrent fever. Imaging revealed a paraureteral mass beneath the right kidney. The final pathological biopsy results indicated CD20 (+), a mature B - cell tumor. However, the patient declined further tests to determine the specific type of lymphoma and subsequent treatment, and requested discharge. Unfortunately, the patient passed away in mid - November 2020.
Conclusions: This case report highlights that lymphoma patients may present with acute myelitis as the first symptom, especially when accompanied by recurrent fever. Conventional myelitis treatment may be ineffective in such cases. Once other causes of myelitis have been excluded, tumors should be considered. Moreover, a targeted search for tumor - related evidence, along with early detection and treatment, may potentially improve patient survival.
Keywords: Acute Myelitis; Mature B - Cell Lymphoma; Secondary Central Nervous System Lymphoma; Case Report
