To illustrate the multifaceted imaging appearance of primary and secondary spinal lymphomas.

♦ Introduction: While lymphoma is a rather common malignancy, spinal involvement is rare (accounting for 1-2% of extranodal lymphomas and 10% of all epidural tumors) [1]. Spinal lymphoma is mostly encountered in the setting of systemic disease, usually non-Hodgkin lymphoma (NHL), especially the diffuse large B-cell subtype [2]. Vertebral involvement in Hodgkin’s disease (HD), can occur with extranodal stage IV lymphoma [3]. Spinal lesions are present in 1% of primary Central Nervous System (CNS) lymphoma and 3% of systemic CNS lymphoma [4]. Spinal lymphomas have...

We retrospectively reviewed the CT and MRI examinations of 20 patients with spinal lymphoma, 18 NHL cases (4 primary/14 metastatic) and 2 patients with primary osseous HD, performed within a 2-year-period. The majority of patients were middle-aged, with a slight male predilection. NHL exhibited a lytic-destructive and multifocal/diffuse pattern in 15/18 patients, half of which presented with accompanying soft-tissue mass [Fig 7]. A solitary lytic-metastatic lesion was seen in one case [Fig.8], whereas multiple mixed sclerotic-lytic lesions were found in two patients [Fig.9, Fig.10]. There...

Spinal lymphoma is mostly encountered as metastatic dissemination in non-Hodgkin's disease, demonstrating a destructive multifocal pattern, usually nonspecific. Sclerotic lesions are rare, commonly associated with Hodgkin's lymphoma. A high index of suspicion, based on recognition of characteristic imaging features, may suggest the diagnosis. However, histopathologic analysis is required for definitive diagnosis. [2] Regardless of the non-specific, varied, imaging appearance, lymphomatous infiltration should always be considered in case of spinal lesions in any patient >40y.

[1] Moussalya E., Nazhaa B., Zaaroura M., Atallahb JP. Primary Non-Hodgkin’s Lymphoma of the Spine: A Case Report and Literature Review. World J Oncol. 2015; 6(5): 459-463. DOI: 10.14740/wjon947w, PMID: 28983348 [2] Lim CY, Ong KO. Imaging of musculoskeletal lymphoma. Cancer Imaging 2013; 13(4): 448-457. DOI: 10.1102/1470-7330.2013.0036, PMID: 24334414 [3] Pawha PS, Chokshi FH. Imaging of Spinal Manifestations of Hematological Disorders. Hematol Oncol Clin N Am 2016; 30: 921–944. DOI: 10.1016/j.hoc.2016.03.011, PMID: 27444004 [4] Jiménez de la Peña M., Vicente LG, Alonso RC, Cabero SF,...