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  • Title: Wrap-Around Appearance: Underrecognized Radiologic Feature of Spinal Lymphoma.
    Author: Patel M, Wu OC, Kasliwal MK.
    Journal: World Neurosurg; 2018 Jul; 115():157-158. PubMed ID: 29678712.
    Abstract:
    A 71-year-old man presented with neck and upper back pain to the emergency department. Magnetic resonance imaging of the thoracic demonstrated a T2 vertebral lesion with epidural spinal cord compression. Considering the degree of severe spinal cord compression and the absence of a pathologic diagnosis, an urgent separation surgery was planned. A frozen section of the tumor from the paraspinal mass during initial exposure confirmed the presence of lymphoma, and hence only a T2 laminectomy and decompression were performed. Final pathology was non-Hodgkin lymphoma. Careful evaluation of the magnetic resonance image shows the presence of circumferential epidural spinal cord compression along with involvement of the posterior elements in a characteristic "wrap-around" fashion. Recognition of this finding may steer the surgeon toward a differential of spinal lymphoma, and its clinical importance cannot be overemphasized.
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