Introduction

Primary spinal epidural lymphomas (PSELs) comprise a group of tumors, which are present only in the spinal epidural space, with a histopathological picture of lymphoma, and negative diagnostic workup for lymphoma at other sites.1 Epidural location of lymphomas, both Hodgkin’s and non-Hodgkin’s is very rare due to which the diagnosis is challenging. About 24-48% of non-Hodgkin’s lymphomas (NHLs) were found to have extranodal origin.2,3However, PSEL accounts for only 0.9% of all extranodal NHLs.4 There are many cell types of NHLs, DLBCL is the most common form which accounts for only 1.8% of all (nodal and extranodal) DLBCLs.5 It is easily missed and maybe misdiagnosed leading to lack of timely intervention and unhindered progression of the tumor.
This report describes the clinical features, imaging characteristics, and histopathological features of the rare case of primary spinal epidural diffuse large B-cell lymphoma (DLBCL). To the best of our knowledge, this is the first reported case of primary spinal epidural DLBCL from Nepal. It also emphasizes the importance of a multidisciplinary approach for the successful treatment of this disease.