Extranodal classical Hodgkin lymphoma involving the spinal cord: case report and review of the literature

Figures & data

Figure 1. Patient 1.

Sagittal T1-weighted MRI showing an intra medullary spinal cord lesion from T10 to L1 levels (arrow).

Figure 2. Atypical spinal cord lymphoma infiltration.

Transversal and sagittal slides from PET showing intramedullary signal in front of T10 to L1 vertebrae. The arrows show a hypermetabolic lesion located in the spinal cord.

Figure 3. Patient 2.

Sagittal T1-weighted MRI showing an intramedullary mass regarding T2 vertebrae (arrow).

Table 1. Literature review.

Study (year)	Gender	Age (years)	Imaging/level if available	Lymph nodes association	Treatment	Response or survival at the end of treatment	Ref.
Lyding et al. (1987)	Female	32	Intraspinal tumor/C6–C7	Yes	45 Gy of mantle field irradiation/5 cycles of MOPP	CR at the end of treatment	[6]
Higgins et al. (1995)	Male	46	Intraspinal, extradural, extra medullary tumor/ C5–T8	No	Laminectomy, 8 cycles of MOPP-ABV, 30 Gy irradiation	CR at 21 months	[7]
Jardin et al. (1999)	Female	36	Intraspinal tumor/ C8–T1	No	Intrathecal chemotherapy	Death at 2 months	[8]
Riffaud et al. (2003)	Male	14	Lumbar spinal lesion	Yes	Surgery, 6 cycles of AVD like chemotherapy/21 Gy of mantle field irradiation	CR at 1 year of the end of treatment	[9]
Heran et al. (2006)	Male	42	Lower cervical spinal mass	No	Surgical biopsy, ABVD (number of cycles not provided)	CR at the end of treatment	[10]
Kilani et al. (2006)	Male	32	Transverse myelitis T6–T7	Yes	None	Early death	[11]
Al Khayat et al. (2007)	Female	42	Para spinal mass/C7–T1	No	Cervical surgical biopsy, 4 cycles of ABVD and 30 Gy irradiation	CR at 12 months	[12]
Samadian et al. (2009)	Male	12	Epidural mass/L1–L3	No	Laminectomy, 6 cycles ABVD, 24 Gy irradiation	CR and alive at 7 years	[13]
Chotai et al. (2010)	Male	24	Caudal mass/L5–S3	No	Laminectomy/3 cycles of ABVD (treatment interrupted by the patient)	PR at 12 months	[14]
Yaman et al. (2013)	Male	30	Epidural tumor/T9–T11	No	Laminectomy, 6 cycles of ABVD	CR at 24 months	[15]
Martinez et al. (2014)	Female	74	Lumbar intramedullary 1.4 cm mass and an enhancing lesion at the pontomedullary junction and involving the left middle and inferior cerebellar peduncle	No	Lumbar surgical biopsy, cerebral and lumbar 36 Gy irradiation	CR at 6 months	[16]
Williamson et al. (2020)	Female	48	Two spinal lesions regarding L1–L2 and L5–S1	No	Laminectomy, 36 Gy irradiation	CR at 10 months	[17]
Bloxham et al. (2021)	Female	15	Epidural mass regarding L3, L4 and L5	Yes	Surgical decompression/2 cycles of OEPA, 4 cycles of COPDAC and irradiation (dose not provided)	PR before irradiation	[18]

ABVD: Doxorubicin, bleomycin, vinblastine, dacabazine; COPDAC: Cyclophosphamide, vincristine, prednisone, dacarbazine; CR: Complete response; MOPP: Mechloretamine, vincristine, procarbazine, prednisone; OEPA: Vincristine, etoposide, prednisone, doxorubicin; PR: Partial response.

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