Cerebrospinal fluid infiltration in Hodgkin lymphoma: a case report.
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.
Sachdeva
Man Updesh Singh
MU
Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Suri
Vikas
V
Malhotra
Pankaj
P
Srinivasan
Radhika
R
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
D000970:Antineoplastic Agents; D008727:Methotrexate