Diffuse follicle center lymphoma of the spine: A primary epidural lymphoma?

A 72-year-old right-handed woman presented with a 6-month history of right thoracic wall discomfort. An MRI of the thoracic spine showed a small dumbbell-shaped mass centered within the right T7-8 foramen. The patient was asked to return to clinic for reevaluation to include a new MRI of the thoracic spine in 6 months. She did not comply with this recommendation and 1 year later, she presented with increasing difficulty ambulating and spastic paraparesis. A follow-up MRI of the thoracic spine now demonstrated significant interval growth of the mass with an extra-foraminal component extending into the thoracic cavity. She was taken to the operating room for resection of the epidural tumor. The pathology was consistent with diffuse follicle center lymphoma as cells were immunohistologically positive for CD20, CD10, BCL-2 and BCL-6. Primary spinal follicle center lymphomas of the spine are rare with the current case being the first diffuse follicle center type reported in the literature.