Hodgkin's lymphoma presenting as extradural spinal cord compression

Hodgkin's lymphoma presenting with spinal cord compression is rare. Reports estimate that only 5% of patients with Hodgkin's lymphoma have spinal cord compression. The objectives of this study were:- (1) To review the histology of all cases of Hodgkin's lymphoma causing spinal cord compression. (2) To correlate the findings with the clinical details- lymphadenopathy, hepatosplenomegaly, and marrow involvement.

This was a retrospective study, the period of study being between 1987-2002. All cases were taken from the histopathology record files, pathology department, NIMS, Hyderabad. The clinical profile of each case was noted and the histology reviewed. When necessary, immunohistochemistry with the necessary markers was performed.

There were 12 cases, of which 11 were males, and one was a female. The patients ranged from 8-62 years of age, with a median age of 32 years. The cord involvement was at different levels- thoracic(8), lumbar(2) and cervical(2).

The histologic diagnosis of Hodgkin's lymphoma presenting as cord compression requires awareness of the condition. The close differential diagnoses include non-specific inflammation, non-Hodgkin's lymphoma, tuberculosis and eosinophilic granuloma. Detailed clinical evaluation is essential for interpreting the histology.