Lymphomatous Leptomeningitis as a Presenting Syndrome of Hodgkin's Disease

Hodgkin's disease of the thoracic vertebrae

“…Half of the cases of spinal cord compression were found at the time of initial diagnosis. Spinal cord compression occurs much less often in Hodgkin's disease [10][11][12]. To our knowledge, the case described here is only the ninth case and the third report of a patient with Hodgkin's disease who presented with spinal cord compression due to epidural and spinal disease without lymphoma 11 elsewhere [13][14][15].…”

Primary intradural extraarachnoid Hodgkin lymphoma of the cervical spine

“…9 Secondary intradural spread, either intramedullary or leptomeningeal, is rare in Hodgkin disease, usually presenting late after systemic therapy, and is associated with a poor prognosis. 10,12,17,20 There have been no reports of primary Hodgkin lymphoma located in the intradural compartment. 10,12 It is difficult to comment on the cell of origin in this location because no aggregates of lymphoid tissue are present within the intradural compartment.…”

“…Within the spinal cord, Hodgkin lymphoma appears to spread directly among structures such as paravertebral masses, along the neural foramina, or intradural metastases. 1,2,7,[9][10][11][12]16,17,20 This differs from the hematopoietic spread to the vertebrae that is characteristic of other tumors. 1,2,7,9,11,16,20 In our case the initial onset of radicular pain may have been associated with the tumor arising within the root sleeve and extending farther intradurally.…”

A 42-Year-Old Male with Recent-Onset Dementia

“…In the absence of intracranial Hodgkin's disease, there may be an assumed paraneoplastic syndrome associated with Hodgkin's disease (2). This is fairly important in the management of these patients because, obviously, the systemic disease must be treated if it is the etiology of the CNS involvement.…”