Abstract: A case of intravascular large Bcell lymphoma(IVLBCL) with myelopathy as the first manifestation and confirmed by stereotactic  brain biopsy in the department of neurology of PLA Strategic Support Force  Characteristic Medical Center was reported and analyzed. The diagnosis process was complicated. The myelopathy lesions were reduced after early treatment with methylprednisolone and rglobulin.The  changes  of intracranial lesions  were multiterminal,  with  recurrent symptoms and progressive aggravation.The patient was finally  diagnosed with a  definitive  brain  biopsy and died in the  4th month of the course of the disease. For myelopathy lesions with unclear diagnosis and poor therapeutic effect,  it is necessary to keep a high level of vigilance  and conduct biopsy to the maximum extent to avoid entering the diagnostic trap.

Key words: myelitis；lymphoma; , Bcell；central nervous system