Primary central nervous system Hodgkin Lymphoma: A case discussion and a hypothesis on the etiology

Alfaseh, Ahmad; Rajeh, M. Nabeel; Hamed, Ghiath

doi:10.4103/ajm.ajm_104_18

Cited by 9 publications

(9 citation statements)

References 14 publications

(19 reference statements)

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“…Central nervous system involvement is rare with HL, accounting for 0.2-0.5% of all cases [1], and mostly occurs as a relapse. Due to the rare occurrence, only 22 cases to date have been reported in the literature [1,[3][4][5]. In contrast, CNS involvement is 5-30% in patients with NHL [2].…”

Section: Discussionmentioning

confidence: 99%

Atypical involvement of central nervous system in classic Hodgkin lymphoma: a case report

et al. 2021

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Background Hodgkin lymphoma is a systemic disease that commonly involves the cervical, supraclavicular, and mediastinal lymph nodes. The involvement of central nervous system in Hodgkin lymphoma is extremely rare, and diagnosis is usually established using distinct morphological and immunohistochemical staining on the tissue biopsied. Extranodal presentation of HL is a rare occurrence. It has been evident that prognosis is encouraging in patients with disease that is limited to just central nervous system initially or as relapse, compared with involvement of multiple sites of relapse. Case presentation We herein report a case of a 35-year-old South-East Asian male with relapsed Hodgkin lymphoma. The patient developed a parotid gland lesion, cervical lymphadenopathy with significant weight loss, and intermittent night sweats. Along with spread to the central nervous system, there was a high suspicion of tuberculosis. Upon biopsy of his cervical lymph node, the patient was confirmed to have Hodgkin lymphoma. Immediate treatment began with six cycles of chemotherapy consisting of adriamycin, bleomycin, vinblastine, and dacarbazine. The patient received three cycles of chemotherapy consisting of ifosfamide, carboplatin, and etoposide but then was lost to follow-up. Five years later, the patient suffered a road traffic accident. Upon work-up, a right parietal space-occupying lesion with moderate cerebral edema and midline shift was found on computed tomography of the brain. The patient underwent resection of the space-occupying lesion of brain, with features consistent with classical Hodgkin lymphoma on histopathology examination. It is crucial for such lesions to be investigated meticulously to rule out any secondary disease process. Conclusion Relapsed Hodgkin lymphoma with central nervous system involvement is relatively rare with just over two dozen cases reported to date and is observed infrequently in developing nations. Therefore, space-occupying lesion should always be investigated, and biopsy of such lesions is gold standard to establish diagnosis. With timely appropriate therapy, complete remission can be achieved. However, large-scale studies would be prudent to explore the presentation, survival, and treatment options for patients with Hodgkin lymphoma involving the central nervous system.

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Section: Discussionmentioning

confidence: 99%

Atypical involvement of central nervous system in classic Hodgkin lymphoma: a case report

et al. 2021

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“…Due to the absence of lymphoid tissue in this area, it is difficult to determine the cancer-initiating cell as there is no evidence of systemic disease burden or extradural disease. The role of regulatory T cells has been hypothesized in CNS HL pathogenesis, as there has been an associated high number of these cells present in affected tissue [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Primary intradural Hodgkin lymphoma of the conus medullaris and cauda equina: case report

et al. 2020

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Primary Hodgkin lymphoma of the central nervous system is an exceedingly rare condition with very few cases reported in the literature. Isolated intradural involvement of the spine is rarer still, with only two prior cases located in the extramedullary cervical and lumbosacral spine. We present a 48-year-old female who was presented with back pain, radiculopathy and a short history of sphincter disturbance and was subsequently found to have a lobulated homogenously enhancing exophytic lesion involving the conus medullaris and cauda equina on magnetic resonance imaging. Histopathological examination demonstrated the features of classic Hodgkin lymphoma. In this report, we present a case of primary intramedullary Hodgkin lymphoma involving the conus medullaris and cauda equina.

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“…Primary intracranial HL at presentation is an exceedingly rare occurrence. Since the irst case report of Ashby, et al in 1988 [6], convincingly supported by a limited immunohistochemical assay, additional 30 cases of initial presentation of intracranial HL have been reported to date, as isolated case reports and more recently in two case series [2,5,[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Among these cases, only 16 were an isolated intracranial inding, with no evidence of a systemic disease [2,[5][6][7][8][9][10][11][17][18][19][20][21], neither at staging, nor at follow-up (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Primary intracranial Hodgkin’s lymphoma after a blunt trauma: A case report

Riccioni¹,

Cremonini²,

Gessaroli³

2020

J Neurosci Neurol Disord

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We report a case of 30-year-old immunocompetent man, with a previous history of cranial-facial trauma, who presented with progressive left exophthalmos due to an intracranial left frontal-ethmoidal-orbital mass. Histology of the resected tumor revealed a classical Hodgkin’s Lymphoma (HL). Epstein-Barr virus encoded RNA/EBER was detected in typical Hodgkin and Reed-Sternberg cells. After postoperative radiotherapy and chemotherapy administration, the patient remains free of systemic disease or recurrence on 4 years of follow-up. Intracranial involvement by HL has rarely been described, mostly as a late localization or as a recurrence of a disseminated disease, in a setting of immunosuppression. Primary HL of the central nervous system occurring as an isolated disease is even more uncommon, with only 16 reported cases documented to date. The prognosis of these rare cases appears comforting with appropriate treatment. Tumor resection and, in appropriate cases, treatment with radiation and/or chemotherapy seem to warrant a durable response. For this reason a systemic disease should be excluded in all cases intracranial HL by a comprehensive work-up. To the best of our knowledge, this case represents the first report that documents the association of intracranial HL and local trauma with subsequent intracranial infection.

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Primary central nervous system Hodgkin Lymphoma: A case discussion and a hypothesis on the etiology

Cited by 9 publications

References 14 publications

Atypical involvement of central nervous system in classic Hodgkin lymphoma: a case report

Atypical involvement of central nervous system in classic Hodgkin lymphoma: a case report

Primary intradural Hodgkin lymphoma of the conus medullaris and cauda equina: case report

Primary intracranial Hodgkin’s lymphoma after a blunt trauma: A case report

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