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Updated: Jun 12, 2026
05:53
Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
20 year old lady with a paraspinal mass.
Orna O'Toole1, Alan O'Hare, Liam Grogan
1Department of Neuropathology, Beaumont Hospital, Dublin, UK.
Brain Pathology (Zurich, Switzerland)
|June 5, 2010
Summary
This case study details a rare instance of central nervous system Hodgkin's Lymphoma (CNS-HL) mimicking a spinal tumor. The patient's initial symptoms and imaging suggested a neurofibroma, highlighting diagnostic challenges in rare CNS-HL presentations.
Area of Science:
- Neurology
- Oncology
- Radiology
Background:
- Central nervous system Hodgkin's Lymphoma (CNS-HL) is a rare condition.
- CNS-HL can present as parenchymal or dural-based lesions, often intracranial.
- Mixed cellularity type Hodgkin's Lymphoma carries an increased risk of CNS involvement.
Observation:
- A 20-year-old female presented with progressive upper and lower limb neurological deficits.
- Initial MRI revealed an intradural extramedullary mass at C7-T1, suspected to be a plexiform neurofibroma due to rapid growth.
- Subsequent imaging showed significant spinal cord compression from C5 to T3.
Findings:
- Surgical resection and histopathology confirmed Hodgkin's Lymphoma (mixed cellularity type), not a neurofibroma.
- Further investigation identified a stage IV mediastinal mass, confirming systemic Hodgkin's Lymphoma.
- This case represents the first reported instance of CNS-HL radiologically mimicking a paraspinal plexiform neurofibroma.
Implications:
- This case underscores the importance of considering rare diagnoses like CNS-HL in the differential for spinal masses, especially with rapid progression.
- Accurate radiological differentiation between neurofibromas and CNS-HL can be challenging, necessitating a high index of suspicion.
- Early diagnosis and treatment of CNS-HL are crucial, as demonstrated by the patient's response to ABVD chemotherapy.
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