Abstract
Classic Hodgkin lymphoma (cHL) primarily affects the lymphatic system; however, extranodal involvement occurs in approximately 10% of cases. Central nervous system (CNS) involvement, though rare, can present in various forms, including intracranial, epidural, leptomeningeal, and intramedullary spinal cord involvement. This report presents a case series of two unique cases of cHL with intracranial extra-axial extension. Case 1: 31-year-old male with Stage IVB mixed cellularity cHL presented with ataxia and weakness with intermittent fevers. Case 2: 28-year-old female with cHL presented with neck swelling and persistent lymphadenopathy. Both were treated with both novel combination and conventional chemotherapy regimens. Treatment with Adcetris-Adriamycin, Vinblastine, Dacarbazine (A-AVD) has demonstrated superior efficacy compared to traditional Adriamycin, Bleomycin, Vincristine, Dacarbazine (ABVD) chemotherapy. Notably, progression-free survival has been observed to be higher with nivolumab-AVD (N-AVD) compared to brentuximab-AVD (B-AVD). A literature review of intracranial Hodgkin’s lymphoma (HL) case reported from 1998 to 2024 documented in various locations separated based on tissue diagnosis type, treatment type and Epstein-Barr virus (EBV) positivity documented complete remission especially with appropriate timely therapy. CNS involvement in cHL is uncommon as observed in these cases which necessitates a thorough diagnostic workup to exclude infections and other malignancies. Diagnosis relies on imaging studies followed by histopathological confirmation. Emerging therapies such as N-AVD have shown improved progression-free survival in patients with advanced-stage cHL.
Published on: February 21, 2025
doi: 10.17756/micr.2025-112
Citation: Singh KB, Muthyala K, Pierotti D, Martin B, Morrison E, et al. 2025. Case Series and Literature Review of Rare Intracranial Presentations of Classic Hodgkin Lymphoma. J Med Imaging Case Rep 9(1): 1-6.
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