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Background: Primary spinal epidural non-Hodgkin' s lymphoma (PSENHL) is an uncommon disease.Most PSENHL are diffuse large B-cell lymphomas, and thoracic spine is the most common site of involvement.Primary spinal epidural B-lymphoblastic lymphoma (LBL) is particularly rare.So far only one case at thoracic segment was reported.Case Presentation: A 16-year-old female presented with a history of pain in her lower back and lower extremities for 7days, pain aggravated and weakness for 4 days, urinary incontinence for 2 days.Magnetic resonance imaging (MRI) scan revealed an extradural mass lesion at mid L3 to L5 level, which was at first suggestive of a neurogenic tumor.L4-L5laminectomy was performed and tumor was totally resected.Histopathological examination after surgery revealed B-lymphoblastic lymphoma (LBL) /-acute lymphoblastic leukemia (ALL).Postoperative blood counts, bone marrow biopsy and aspiration were negative.The final diagnosis of primary spinal epidural B-LBL was made.Patient was treated with vincristine,daunorubicin, cyclophosphamide, L-asparaginase and prednisone after surgery.After 2 month of follow up, all the symptoms were relieved.Conclusion: Primary spinal epidural non-Hodgkin' s lymphoma should be considered in the differential diagnosis of the patients who present with spinal cord or cauda equina compression.This is the first primary spinal epidural B-LBL at lumbar reported as we known.