Cervical radiculopathy as the presenting feature of a non-Hodgkin lymphoma

Introduction. Neurological involvement in non-Hodgkin lymphoma is usually a serious problem leading to subacute compression of the the spinal cord secondary to invasion of the spinal extradural space. This condition may be the presenting form of the illness, although relatively infrequently. Onset with involvement of the cauda equina or as an isolated radiculopathy, is even rarer and has mainly been described at lumbar level. Clinical case. We present the case of a 27 rear old man with no significant previous clinical history who had progressive, insidious onset of moderate-serious senso-motor radiculopathy at C8. On MR there was an infiltrating mass affecting the nerve root and reaching the spinal extradural space. Following decompression laminectomy the patient's leg recovered and on histology there was a large cell B lymphoma. The other complementary tests showed disseminated disease, although analysis of the cerebro-spinal fluid (including cytology) was normal. HIV seriology was also normal. Conclusion. Although isolated nerve root involvement is unusual in the presentation of lymphoma it should be considered to be part of the differential diagnosis of nerve root syndromes in young patients with no history of trauma or degenerative lesions [REV NEUROL 1998; 27: 91-3].