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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 9/2014

01-09-2014 | Case Study

Primary EBV-positive Hodgkin’s lymphoma of the CNS under azathioprine treatment

Case report and review of the literature

Authors: Christoph Henkenberens, MD, Anke Franzke, MD, Peter Raab, MD, Ilske Oschlies, MD, Wolfram Klapper, MD, Hans Christiansen, MD

Published in: Strahlentherapie und Onkologie | Issue 9/2014

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Abstract

Background

Retrospective and prospective cohort studies suggest that central nervous system involvement occurs in approximately 0.5 % of patients with advanced Hodgkin’s lymphoma. The isolated primary intracranial manifestation of Hodgkin’s lymphoma is an extremely rare finding, with few cases reported in the literature. Little is known about the optimal treatment and prognosis of these tumors. Here, we present a case report with a review of the literature.

Case presentation

A 47-year-old Caucasian man with persistent frontal headache and unspecific vertigo for half a month was diagnosed with nodular space-occupying lesions in the cerebellum. His medical history included multiple sclerosis, which was treated for 20 years with the immunosuppressive drug azathioprine. Further staging revealed no additional lesions suspected of being malignant. The patient underwent total tumor resection. Immunohistopathological examination showed Epstein–Barr virus-associated classic Hodgkin’s lymphoma. Diagnostic bone marrow punction excluded lymphoma involvement of the bone marrow. The patient had no B symptoms. Consequently, the patient was classified as having stage IEA disease according to the Modified Ann Arbor Classification of Hodgkin Lymphoma and received systemic chemotherapy followed by radiation therapy for the former cerebellar tumor region. He was in complete clinical remission atthe last follow-up 9 months after the initial diagnosis.

Conclusion

This case report and literature review suggest that multimodal treatment leads to a remarkable clinical outcome in Hodgkin’s lymphoma with intracranial involvement.
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Metadata
Title
Primary EBV-positive Hodgkin’s lymphoma of the CNS under azathioprine treatment
Case report and review of the literature
Authors
Christoph Henkenberens, MD
Anke Franzke, MD
Peter Raab, MD
Ilske Oschlies, MD
Wolfram Klapper, MD
Hans Christiansen, MD
Publication date
01-09-2014
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 9/2014
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-014-0670-9

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