title: Cerebrospinal fluid infiltration in Hodgkin lymphoma: a case report.
abstract: BACKGROUND
  Central nervous system (CNS) involvement by Hodgkin lympboma is a rare event. Involvement of the cerebrospinal fluid (CSF) in such cases is even more uncommon. We report a case of Hodgkin lymphoma in which the patient developed infiltration of the CSF while on chemotherapy.
  
  
  METHODS
  A 45-year-old woman was diagnosed with Hodgkin lymphoma by fine needle aspiration and subsequent biopsy of the cervical lymph node. She complained of headache during the course of chemotherapy, for which CSF examination was undertaken. Cytocentrifuge sediment of the CSF revealed marked eosinophilic pleocytosis, accompanied by scattered monocytes, polymorpbs, lymphocytes, plasma cells and histiocytes. An occasional large mononudlear cell with a large, round nucleus and prominent irregular nucleolus with a moderate amount of basophilic cytoplasm conformning to the morphology of Hodgkin's cells was noted. Binucleated Reed-Sternberg cells were not seen. Following intratbecal methotrexate, a reduction in the cellular infiltrate was observed.
  
  
  CONCLUSIONS
  CSF cytology is important for the diagnosis of CNS involvement by Hodgkin lymphoma and may be positive before lesions can be visualized by magnetic resonance imaging or computed tomograpby scans.
authors.affiliation: Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Man Updesh Singh
authors.initials: MU
authors.lastname: Sachdeva
authors.forename: Vikas
authors.initials: V
authors.lastname: Suri
authors.forename: Pankaj
authors.initials: P
authors.lastname: Malhotra
authors.forename: Radhika
authors.initials: R
authors.lastname: Srinivasan
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D044963:Biopsy, Fine-Needle; D002555:Cerebrospinal Fluid / Q000166:cytology; D004802:Eosinophilia / Q000473:pathology; D005260:Female; D006689:Hodgkin Disease / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000473:pathology; D007964:Leukocytosis / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D009333:Neck; D016539:Reed-Sternberg Cells / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents; D008727:Methotrexate