淋巴瘤是免疫系统恶性肿瘤，起源于淋巴器官，可能影响中枢神经系统。但是，以急性脊髓炎为首发症状的淋巴瘤非常罕见，大多数是由于其临床表现缺乏特异性而视为脊髓损伤的症状。早期误诊率极高，预后不良。在这里，我们报告了一例以急性脊髓炎为首次表现的成熟B细胞淋巴瘤，并回顾了相关文献。在这项研究中，我们报告了一位70岁男性患者，表现为双侧下肢无力，肠膀胱功能障碍和反复发热。影像学显示右肾下方有一个邻近输尿管的肿块，最终病理活检显示：CD20（+），成熟B细胞肿瘤。患者拒绝进行额外的测试以确定淋巴瘤的类型和后续治疗，并要求出院。2020年11月中旬，患者去世。这个病例报告显示淋巴瘤患者可能以急性脊髓炎作为首要症状，特别是如果他们有反复发热，常规的脊髓炎治疗无效，并且在排除了其他脊髓炎原因之后才考虑肿瘤。此外，有关肿瘤相关证据的集中搜索以及早期识别和治疗可能有助于延长患者的生命。©2023。作者（们）。

Lymphomas are malignant tumors of the immune system that arise in lymphoid organs and can impact the central nervous system. However, lymphomas with acute myelitis as the first manifestation are exceedingly rare, and most of them are symptoms of spinal cord damage due to the lack of specificity in their clinical manifestations. The rate of early misdiagnosis is exceedingly high, and the prognosis is dire. Here, we report a case of mature B-cell lymphoma with acute myelitis as the first presentation and review the related literature.In this study, We report a case of a 70-year-old male patient with bilateral lower extremity weakness, bowel and bladder dysfunction, and recurrent fever. A paraureteral mass was seen beneath the right kidney on imaging, and the final pathological biopsy revealed: CD20 ( +), mature B-cell tumor, The patient refused to undergo additional tests to ascertain the type of lymphoma and subsequent therapy and asked to be discharged. In mid-November 2020, the patient died.This case report shows that patients with lymphoma can present with acute myelitis as the first symptom, especially if they have recurrent fever, that conventional treatment for myelitis is ineffective, and that tumors are considered after other causes of myelitis have been ruled out. Furthermore, a focused search for tumor-related evidence, as well as early identification and therapy, may help patients live longer lives.© 2023. The Author(s).