e19039 Background: Primary non-Hodgkin lymphomas of thoracic vertebra are rare, hard to confirm the diagnosis and with unfavorable prognosis. It is characterized by pain, asthenia, numbness, motor disturbances, etc. However, these symptoms don’t have their specificity. Biopsies are needed to confirm the diagnosis. Methods: A 37-year- old man presented with 3 months lumbar region pains and 4 days motor disturbances before he was admitted. The lumbar spine MRI showed lumbar disc herniation with no spinal compression. The thoracic spine MRI revealed altered vertebra signal and compressed marrow in the T10 vertebra. After the posterior tumor reduction and decompression and internal fixation of T10, the histopathology and immunohistochemistry was consistent with diffuse large B cell lymphoma. After surgery, treatment of chemotherapy (ECHOP, RCHOP) in combination with radiotherapy (T8-T12, L5-S1, 45Gy/25F) were followed. Results: Six-year follow-up MRI showed no relapses, metastasis and instability. The patient currently has the self-care ability which could deal with the everyday activities. Conclusions: Primary non-Hodgkin lymphoma originated in the thoracic vertebra is rare, easily to be misdiagnosed. To learn more about the diagnoses and to do the needle biopsy as early as possible would be beneficial to improve the survival rate and the quality of patients’ lives. Key words: Non-Hodgkin Lymphoma, Thoracic Vertebra, Case Report