Here we report a non-Hodgkin’s lymphoma (NHL) with initial manifestation as spinal cord compression fracture. A 23-year-old male presented to our emergency room with refractory lower back pain and deteriorating neurological presentations. An intraspinal tumor of the 12th thoracic vertebral body causing a total compression fracture was confi rmed. Result of tissue biopsy and PET scan proved NHL without nodal involvement. Eight courses of anti-CD20 monoclonal antibody combined with chemotherapy, but without radiotherapy which was taken as the standard treatment in primary bone lymphoma,were prescribed. The patient survived for 3 years without tumor recurrence. Anti-CD20 monoclonal antibody,
instead of radiotherapy, may provide an alternative treatment of choice for patients with primary bone lymphoma (PBL).