Spontaneous Regression Of Malignant Lymphoma Of The Lumbar Spine
Ohgi, S., Ehara, S., Satoh, T., Kato, S., Shimosegawa, K., & Ishida, Y. (2002). spontaneous regression of malignant lymphoma of the lumbar spine. Skeletal radiology, 31(2), 99–102. https://doi.org/10.1007/s00256-001-0446-z
View Original Source →Abstract
Spontaneous regression of diffuse B-cell type lymphoma of the lumbar vertebra is reported. A 61-year-old woman experienced spontaneous disappearance of a large psoas mass associated with an infiltrating process of the lumbar vertebrae. The biopsy of the residual change after spontaneous regression revealed reactive foamy histiocytes and small lymphocytes with no atypia. The lesion recurred 7 months later with no systemic treatment in the interim, when the diagnosis of lymphoma was finally made. Spontaneous regression may be related to potentiation of the host immune response, which affects tumor growth.
Case Details
Disease Location
Lumbar spine
Personal Characteristics
61 -year-old female, japanese
Clinical Characteristics
Presented with a persistent pain in her lower left extremity, the pain was increasing intensity during a 3- months period, she was referred to an orthopedic surgeon where studies were performed hematology and biochemical studies were unremarkable radiographs of the lumbar spine revealed four lumbar vertebrae with collapse and sclerosis of the third lumbar vertebral body MRI of the lumbar spine revealed an infiltrating process in the bone marrow and a large paravertebral soft tissue mass needle biopsy of the marrow of the vertebral body and histology of the specimen showed infiltration by lymphocytes with relatively large and irregular shaped nuclei immunohistochemical findings revealed infiltrating lymphocytes that were CD20 positive malignant lymphoma was compatible with findings but histological diagnosis wasn't made at that time and was referred upon referral, she had flexion contracture of the left hip, representing involvement of the iliopsoas muscle repeat MRI was conducted needle biopsy was not performed but there was surgical biopsy of the abnormal vertebra and stabilization of the posterior elements with plates and screws were performed histology of the surgical specimen showed infiltration by small lymphocytes with no significant cellular atypia and foamy histiocytes, foci of malignant lymphoma were not identified 7 months later, MRI revealed a regrowth of a large mass in the left paravertebral region confluent with the vertebral bodies histology of the open biopsy specimen demonstrated diffuse infiltration by atypical large lymphocytes immunohistochemistry found CD20 positive, and dlbcl was made
Remission Characteristics
The repeat MRI demonstrated disappearance of the infiltrating extraosseous lesion with residual change in the bone marrow regression without chemo after regrowth and chop regimen, complete remission occurred 8 months later
Treatment & Mechanisms
Proposed Remission Mechanisms
Perhaps an immunological process was involved based on histological findings, however mechanism remains unknown
Clinical Treatment
Surgical biopsy with stabilization 4 courses of chop regimen for dlbcl regrowth (cyclophosphamide, doxorubicin, vincristine, predonine)
Non-Clinical Treatment
None reported