CNS Hodgkin lymphoma

Abstract

Central nervous system (CNS) involvement by Hodgkin lymphoma (HL) is rare. As a result, there is limited guidance for clinicians on how to manage these patients. Detailed information was collected on 16 patients, the largest number to date, with meningeal or parenchymal CNS-HL confirmed by histopathology (15) or CSF (1). Eight patients presented with CNS-HL at diagnosis, 2 of whom had isolated CNS disease, while 8 patients developed CNS-HL at relapse. Patients received a range of treatments including surgery or radiation alone, radiation with chemotherapy, or chemotherapy alone. Median overall survival for all 16 patients was 60.9 months from first diagnosis of HL (systemic or CNS) and 43.8 months from diagnosis of CNS-HL. Although a majority of patients have died, long-term survival is possible in patients who achieve a complete response to treatment, particularly those who present with CNS involvement or involvement of the CNS is the sole site of relapsed disease.

Figure 1

Histology from a patient with nodular sclerosis Hodgkin lymphoma involving the cerebellum. A Reed-Sternberg cell () is seen in the center of the panel (40×, hematoxylin-eosin stain) (A). The large cells stained for CD30 (B). The cells are focally CD15 positive (C) and CD45 negative (D). All images were acquired at 40× magnification using an Olympus CX411 microscope and an Olympus DP70 camera with medium acquisition software (Melville, NY).