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MR Imaging Characteristics of Primary T-Cell Lymphoma of the Cauda Equina: A Case Report and Literature Review

말총의 원발성 T세포 림프종에서 MR 영상 소견: 증례 보고와 문헌 고찰

  • Younguk Kim (Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine) ;
  • Guen Young Lee (Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine) ;
  • Sujin Kim (Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine) ;
  • Kwang-sup Song (Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine) ;
  • Hee Sung Kim (Department of Pathology, Chung-Ang University Hospital, Chung-Ang University College of Medicine )
  • 김영욱 (중앙대학교 의과대학 중앙대학교병원 영상의학과) ;
  • 이근영 (중앙대학교 의과대학 중앙대학교병원 영상의학과) ;
  • 김수진 (중앙대학교 의과대학 중앙대학교병원 영상의학과) ;
  • 송광섭 (중앙대학교 의과대학 중앙대학교병원 정형외과) ;
  • 김희성 (중앙대학교 의과대학 중앙대학교병원 병리과)
  • Received : 2020.11.26
  • Accepted : 2021.05.02
  • Published : 2021.11.01

Abstract

Primary central nervous system lymphoma is a rare form of extranodal non-Hodgkin lymphoma, and primary T-cell lymphoma of the cauda equina is extremely rare. We describe a case involving a 56-year-old female who presented with low back pain and radiating leg pain for 4 months. MRI of the lumbar spine revealed an elongated, multinodular intradural lesion of approximately 10 cm from the L4 body to the S2 body level with iso-signal intensity on T1-weighted imaging, heterogeneous iso- and high-signal intensity on T2-weighted imaging, and a heterogeneous intense enhancement on gadolinium contrast-enhanced T1-weighted imaging. A peripheral T-cell lymphoma of the cauda equina was diagnosed on the basis of immunohistochemical and T-cell receptor gamma gene rearrangement analysis after intradural biopsy of the mass.

중추신경계의 원발성 림프종은 비호지킨림프종의 드문 형태이다. 그중에서도 말총의 원발성 T세포 림프종은 극히 드물다. 이 증례 보고는 4개월 전부터 시작된 허리통증과 하지방사통을 주소로 내원한 56세 여성의 증례에 대한 것이다. 요추 MRI에서 10 cm 크기의 길다란 다결절의 경막 내 병변이 4번 요추에서부터 2번 미추까지 있었으며 T1 강조영상에서는 등신호강도이고 T2 강조영상에서는 비균질적인 등신호강도와 고신호강도, 가돌리늄 조영증강 T1 강조영상에서는 비균질적인 강한 조영증강을 보였다. 말총 종괴에 대한 수술적 경막 내 생검을 시행하였고 면역조직화학염색과 T-cell receptor gamma 유전자 재배열 분석을 통한 진단은 말총의 말초 T세포 림프종이었다.

Keywords

References

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