馬尾症候群を初発とした血管内大細胞型B細胞性リンパ腫の1例

Intravascular Large B Cell Lymphoma with Cauda Equina Syndrome: A Case Report and Review of the Literature

症例は62歳男性。1カ月前より出現した歩行障害，膀胱直腸障害の精査目的のために入院した後，意識障害の出現と両下肢麻痺の進行を認めた。ランダム皮膚生検により馬尾症候群を初発とした血管内悪性リンパ腫と診断し，リツキシマブ併用CHOP療法を開始したところ，症状は軽快した。中枢神経症状の合併を伴い，馬尾症候群を初発とした血管内悪性リンパ腫は比較的稀であり，その臨床的特徴について文献的考察を加え，報告する。

Abstract

A 62-year-old man complained of gait disturbance, bladder and bowel dysfunction and paresthesia of both legs one month before admission. His symptoms were suggestive of cauda equina syndrome. After admission, he developed rapid progressive numbness and weakness of both legs and a disturbance of consciousness. A random skin biopsy was performed and a histological diagnosis of intravascular large B cell lymphoma (IVLBCL) was reached. His symptoms were improved after rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) therapy.

(Received July 10, 2015; Accepted September 17, 2015; Published January 1, 2016)