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Case Reports
. 2023 Oct 15;13(5):162-167.
eCollection 2023.

Intracranial disease in pediatric Hodgkin lymphoma-case report and review of literature

Nidhi Dhariwal  1   2 , Nirmalya Roy Moulik  1   2 , Vasudeva Bhat  2   3 , Vasundhara Smriti  2   4 , Sangeeta Kakoti  2   5 , Sayak Choudhury  2   6 , Epari Sridhar  2   7 , Sumeet Gujral  2   7 , Chetan Dhamne  1   2 , Sneha Shah  2   6 , Gaurav Narula  1   2 , Shripad Banavali  1   2
Affiliations
Case Reports

Intracranial disease in pediatric Hodgkin lymphoma-case report and review of literature

Nidhi Dhariwal et al. Am J Blood Res. .

Abstract

Central nervous system (CNS) involvement in Hodgkin lymphoma (HL) is an extremely rare presentation with dismal outcomes according to reported literature. An 8-year-old girl presented to us with complaints of on-off fever, right cervical swelling and bilateral ptosis. Positron emission tomography (PET) showed intracranial extra-axial soft tissue masses in right infero-lateral temporal lobe, sella and bilateral parasellar region along with cervical, mediastinal, axillary, abdominal and inguino-pelvic nodes, liver lesions and extensive marrow lesions involving the axial and appendicular skeleton. Histopathology of the cervical lymph node revealed a diagnosis of classical Hodgkin lymphoma. Child received 2 cycles of OEPA and 4 cycles of COPP followed by radiotherapy to bulky cervical lymph nodes and intracranial lesion. The child has been disease-free for 44 months with no neurological sequalae. Intracranial spread is rare in Hodgkin lymphoma and is associated with inferior outcomes. Due to its rarity, there are no specific treatment guidelines for this entity. The choice of ideal chemotherapeutic agents and role of whole-brain radiotherapy needs further evaluation.

Keywords: Hodgkin lymphoma; central nervous system; intracranial; pediatric.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Baseline CECT of the brain showing dura-based soft lesions with complete resolution in end-of-treatment MRI in (A) axial and (B) coronal section.
Figure 2
Figure 2
PET images showing disease burden at (A) Baseline and (B) after 2 cycles of chemotherapy.
See this image and copyright information in PMC

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