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Case Reports
. 2021 Apr;49(4):300060521999533.
doi: 10.1177/0300060521999533.

Primary central nervous system Hodgkin's lymphoma: a case report

Haiying Fu  1 , Songsheng Shi  2 , Lusan Chen  3 , Benhua Xu  4 , Wanling Huang  1 , Yi Chen  1 , Xuejing Wu  3 , Jianzhen Shen  1 , Tingbo Liu  1
Affiliations
Case Reports

Primary central nervous system Hodgkin's lymphoma: a case report

Haiying Fu et al. J Int Med Res. 2021 Apr.

Abstract

Primary central nervous system Hodgkin's lymphoma (CNS-HL) is extremely rare. This current case report describes a 60-year-old male patient that presented with numbness of the left lower extremity and worsening headache. After a full range of investigations and a partial resection of the right cerebellum, external ventricular drainage reservoir placement and cranioplasty, he was diagnosed with primary CNS-HL. The patient was treated with 3 g/m2 methotrexate (intravenous [i.v.], once a day, day 1) and 1 g/m2 cytarabine (i.v., every 12 h, days 2 + 3), followed by anti-programmed cell death protein 1 antibodies (200 mg sintilimab, i.v., once a day, day 1, every 3 weeks). After six courses of treatment with intrathecal injections of 50 mg cytarabine (once a day, day 1) and 5 mg dexamethasone (once a day, day 1), there was no residual lesion on cranial magnetic resonance imaging. No significant drug-related adverse events were observed. The patient has been followed up every 3 months and no relapse has occurred.

Keywords: Hodgkin's lymphoma; Primary central nervous system; prognosis; programmed cell death-1; treatment.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that there are no conflicts of interest.

Figures

Figure 1.
Figure 1.
Magnetic resonance imaging of a 60-year-old male patient that presented with numbness of the left lower extremity and worsening headache revealed the following: multiple nodules, masses and abnormal signals of Gyri in the bilateral cerebellar hemispheres (a), bilateral cerebellar oedema (arrow) (a) and hydrocephalus (arrow) (b).
Figure 2.
Figure 2.
Pathological examination of the right cerebellar mass of a 60-year-old male patient that presented with numbness of the left lower extremity and worsening headache revealed the following: (a) histological photomicrograph of the biopsy specimen stained with haematoxylin and eosin showing diffuse lymphocytic infiltration with necrosis; (b) scattered large cells with large nucleoli (arrow) within a background of diffuse small lymphocytes; (c) binucleate cells (arrow) within a background of diffuse small lymphocytes; (d) scattered large cells (arrow) within a background of diffuse small lymphocytes; (e) immunohistochemical staining showed the large cells stained for CD30; (f) immunohistochemistry showed that the rate of positive staining for programmed death-ligand 1 was 15%. Scale bar 50 µm. The colour version of this figure is available at: http://imr.sagepub.com.
Figure 3.
Figure 3.
Positron emission tomography-computed tomography imaging findings of a 60-year-old male patient that presented with numbness of the left lower extremity and worsening headache revealed the following: (a) postoperative changes were seen in the right cerebellum. There was no hypermetabolic lesion caused by residual lymphoma in the operation area. There was a left cerebellar tonsillar hypermetabolic lesion, which was considered to be lymphoma infiltration (Deauville Score 5) (images taken on 28 February 2019); (b) compared with previous images taken on 28 February 2019, the right cerebellum showed post-operative changes. The left cerebellar tonsillar infiltrating lesion had receded (Deauville Score 1) (images taken on 19 July 2019). The colour version of this figure is available at: http://imr.sagepub.com.
See this image and copyright information in PMC

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