Extremely Rare Primary Spinal Epidural Indolent Mantle Cell Lymphoma: A Case Report With Literature Review.

Lymphomas are malignant tumors arising from lymphoid tissues and can spread to other organs. Primary extra-nodal locations such as the spinal epidural space are less common. Primary spinal epidural lymphoma (PSEL), which can be either Hodgkin's or non-Hodgkin's type, is rare. There are different cell types of Non-Hodgkin's PSEL, among which mantle cell lymphoma (MCL) is extremely rare. MCL can have an aggressive or indolent course. Indolent MCL in the epidural space is not yet reported. We report a case of 20-year-old male who presented with radiating low back pain for six weeks followed by a progressive neurological deficit in both lower limbs for nine days. Magnetic resonance imaging (MRI) revealed spinal epidural tumor extending from L2 to L3. Decompression and subtotal excision biopsy were performed. Histopathology and immunohistochemistry identified indolent MCL. His neurological status improved to normal postoperatively, and he was referred to an oncologist. He is under observation and planned for radiotherapy. At one-year follow-up, he is asymptomatic and doing his regular job abroad.

Effects on colour discrimination during long term exposure to high altitudes on Mt Everest.

AIM: To investigate changes in colour discrimination as a result of chronic hypoxic exposure induced by extreme altitudes (above 8000 m) during an expedition to Mt Everest. METHODS: Colour discrimination thresholds for tritan, protan and deutan axes were measured extensively in two male participants (four eyes) during an expedition to Mt Everest, using a quantitative, computer controlled psychophysical colour vision test (modified version of the Cambridge Colour Test). The tests were carried out over a period of 54 days at altitudes of 1300 m, 3450 m, 4410 m, 5060 m, 5300 m, 6450 m, 7200 m and 8000 m. RESULTS: Colour vision tests 1 week before and 6 months after the expedition indicated normal colour discrimination in both participants. With increasing altitude, colour discrimination thresholds were found to rise, predominantly for the tritan (blue) axes in both observers. Deutan (green) thresholds were minimally elevated at high altitude, whereas protan (red) was altered in one observer. Tritan colour discrimination thresholds decreased as a function of time spent at a given altitude and normalised upon return to low altitude. CONCLUSIONS: Chronic hypoxia induced by high altitude exposure transiently affects colour discrimination, in particular tritan axis discrimination. Decreased tritan discrimination is partly reversible upon physiological adaptation to high altitude and completely normalised upon return to low altitude.