Hodgkin’s lymphoma presenting as a complex paraneoplastic neurological syndrome: a case report

Abstract

IntroductionParaneoplastic neuropathies are rare. They are often difficult to diagnose, especially when they precede the diagnosis of cancer. Hodgkin's lymphoma is associated with multiple paraneoplastic neurological syndromes, of which demyelinating polyneuropathies are very unusual. Association with chronic inflammatory demyelinating polyneuropathy is even more uncommon.Case presentationWe report the rare case of a 74-year-old Caucasian man who presented with a complex neurological syndrome and was eventually diagnosed with the nodular sclerosing variant of Hodgkin's lymphoma. With timely diagnosis and early institution of treatment of the underlying malignancy, our patient began to show gradual improvement of his symptoms.ConclusionHodgkin's lymphoma is associated with several paraneoplastic neurological syndromes. Sometimes it can be the only presenting feature of an underlying Hodgkin's lymphoma, posing a diagnostic challenge. Prompt oncologic treatment and immunotherapy can be beneficial if instituted early in the course of the disease.

Lymphoma-associated dysimmune polyneuropathies

“…(d) onset of SIDP/CIDP coincided with clinical or subsequent autopsy evidence of lymphoma recurrence [112,114,118,120]; (e) relapse of CIDP/SIDP (also interpreted as recurrent GBS [119]) coincided with diagnosis of new lymphoma [113,117,124,128], and (f) in hindsight, erythematous skin papules (probably related to T-cell lymphoma) preceded initial diagnosis of CIDP by 6 months [124].…”

Three in one: A case presented with multiloculated thymic cyst, thymic Hodgkin lymphoma and pericardial cyst

“…In our case, although the cause of facial nerve involvement could not be determined radiologically, the recovery and nonrecurrence of facial paralysis after lymphoma treatment suggests that there may be a relationship between lymphoma and facial paralysis as paraneoplastic neuropathies are seen in association with 4 to 5% of cancers. [15] Pericardial cysts are also rare masses. It constitutes 4 to 7% of all mediastinal masses.…”

Casebook: a virtual patient iPad application for teaching decision-making through the use of electronic health records

“…As Table 1 shows, the creation of this particular case was performed in just over one working day, using pre-existing material extracted from a case report on the Journal of Medical Case Reports repository [ 27 ]. These times do not take into account any operational challenges that might be expected when creating cases, such as case suitability vetting, de-identification, or case simplification: such aspects were borne by the authors of the case report itself.…”

“…The descriptor file describes the order of the health records, contains any annotations for each of the health records, and contains any questions that appear between health records. Portions of this case, including text, were extracted from a case published in the Journal of Medical Case Reports, an open-access journal where articles are made available under the terms of the Creative Commons Attribution Licence [ 27 ].…”