Primary Peripheral Gamma Delta T-Cell Lymphoma of the Central Nervous System: Report of a Case Involving the Intramedullary Spinal Cord and Presenting with Myelopathy

초록

Primary central nervous system lymphoma of T-cell origin (TPCNSL) is rare, and its clinicopathological features remain unclear. Peripheral T-cell lymphoma of gamma delta T-cell origin is an aggressive lymphoma mainly involving extranodal sites. Here, we report a case of gamma delta T-PCNSL involving the intramedullary spinal cord and presenting with paraplegia. A 75-year-old Korean woman visited the hospital complaining of back pain and lower extremity weakness. Magnetic resonance imaging revealed muttifocal enhancing intramedullary nodular lesions in the thoracic and lumbar spinal cord. An enhancing nodular lesion was observed in the periventricular white matter of the lateral ventricle in the brain. There were no other abnormalities in systemic organs or skin. Laminectomy and tumor removal were performed. The tumor consisted of monomorphic, medium-to-large atypical lymphocytes with pale-to-eosinophilic cytoplasm. lmmunohistochemically, the tumor cells were CD3(+), TCR beta F1(-), TCR gamma(+), CD30(-), CD4(-), CD8(-), CD56(+), TIA1(+), granzyme B(+), and CD103(+). Epstein-Barr virus in situ was negative. This case represents a unique T-PCNSL of gamma delta T-cell origin involving the spinal cord.

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