Tuberculosis of the spine masquerading as a spine lymphoma. A case report and discussion of diagnostic and therapeutic traps

Abstract

Back pain unrelated to trauma or intervertebral disc disease might be due to a primary or metastatic neoplasm or an infection. We report a case treated as an isolated vertebral lymphoma which turned out to be vertebral tuberculosis.

A 59-year-old man with girdle-like thoraco-lumbar pain and impaired function of lower extremities was diagnosed with an isolated vertebral lymphoma. He was put on complete bed rest and began to receive chemotherapy and local radiotherapy. The unexpected clinical improvement led to a reconsideration of the working diagnosis. The appropriate antimicrobial treatment combined with bed rest resulted in rapid recovery and a good functional outcome. The bed rest during the time he received the chemo- and radiotherapy helped considerably in the improvement of his tuberculosis.

A definitive diagnosis demands a histopathological examination which may require a biopsy.