Non-Hodgkin's lymphoma presenting with spinal cord compression; a clinicopathological review of 25 cases

The aim of this study was to retrospectively examine 25 patients with newly diagnosed non-Hodgkins lymphoma (NHL) presenting with spinal cord or cauda equina compression as the first symptom that were referred to our departme nt between 1985 and 1996. At presentation 17 patients were non-ambulatory; dual sphincter impairment was found in 9 patients with a further 8 patients having bladder dysfunction only. All patients had a tissue diagnosis. Five low-grade and 20 intermediate or high-grade tumours were identified. In th is latter group 4 patients were treated palliatively and the remaining 16 p atients received combination chemotherapy and/or radical radiation therapy. The overall survival at 5 years is 59%. The majority of patients became am bulatory, even if paretic at presentation. This is in marked contrast to re ports of patients presenting in this fashion due to metastatic carcinoma. W e urge this diagnosis be considered in all patients presenting with spinal cord compression attributed to malignancy. (C) 2000 Elsevier Science Ltd. A ll rights reserved.