Isolated, primary extranodal Hodgkin's disease of the spine: case report

Abstract

Objective and importance: To describe an unusual case of isolated, primary spinal Hodgkin's disease to draw attention to this disease as a possible diagnosis in patients with mixed inflammatory cell infiltrate lesions located in the spine.

Clinical presentation: A 54-year-old African American woman presented with back pain and progressive lower-extremity weakness as a result of spinal cord compression from Hodgkin's disease of the thoracic vertebrae.

Intervention: The patient underwent decompressive surgery with stabilization, then was incorrectly treated with antituberculosis medication. When the disease progressed, later investigations revealed Hodgkin's disease, which responded to a course of radiation therapy. An extensive examination failed to detect lymphoma elsewhere.

Conclusion: Isolated, primary extranodal Hodgkin's disease of the spine is extremely rare. Seven other cases were reported in 1954. Although the Hodgkin's disease in these cases may arise in the bone of the spine, the possibility of origin in the paraspinous soft tissues also cannot be excluded.