Intravascular large B-cell lymphoma presenting as an isolated cauda equina-conus medullaris syndrome - A case report.

Context: Intravascular large B-cell lymphoma (IVLBCL) is a rare form of Non-Hodgkin lymphoma. The central nervous system, skin and hematopoietic system are the most commonly affected sites. We report a case of IVLBCL presenting as a combined conus medullaris-cauda equina syndrome. Findings: A 55-year-old Caucasian male presented with signs and symptoms of a combined conus medullaris-cauda equina syndrome confirmed by MRI and needle EMG. PET scan revealed a hyperactive focus in the adrenal gland, and biopsy showed evidence of IVLBCL. Therapy with R-CHOP resulted in improvement of weakness. Conclusion: A high index of suspicion and consideration of IVLBCL in the differential for patients with these isolated spinal cord symptoms and CSF findings may help initiate early and suitable therapy which has been proven to be beneficial.