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Vol. 33. Issue 6.
Pages 350-355 (November - December 2022)
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Vol. 33. Issue 6.
Pages 350-355 (November - December 2022)
Case Report
Primary central nervous system Hodgkin lymphoma: A case report and review of the literature
Linfoma de Hodgkin primario del sistema nervioso central. Presentación de un caso y revisión de la literatura
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David Aliagaa,
Corresponding author
Aliagac0810@gmail.com

Corresponding author.
, Juan Mayorgaa, Franscisco Verdú-Lópeza, José María Gallegoa, Laura Castelláb, Vicente Sabaterb
a Department of Neurosurgery, Consorcio Hospital General Universitario de Valencia, 46014 Valencia, Spain
b Department of Diagnostic Pathology, Consorcio Hospital General Universitario de Valencia, 46014 Valencia, Spain
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Abstract

Central nervous system (CNS) involvement in the context of relapsed/refractory Hodgkin lymphoma (HL) is a quite rare, but well-known complication. Nevertheless, primary CNS–HL is an exceedingly rare condition, which diagnosis is based on well-defined morphological and immunohistochemical features, in addition to isolated involvement of the CNS.

In spite of limited casuistry (just over twenty cases reported in the literature), available data agree that primary and isolated CNS–HL, when treated with a combination of surgery followed by some form of adjuvant therapy (radiotherapy±chemotherapy), carries a better prognosis than those cases with CNS involvement in the context of relapsed/refractory HL or those with CNS non-Hodgkin lymphoma.

We herein report a case of a 55-year-old female patient who was diagnosed with primary CNS–HL. The patient was treated with complete surgical resection followed by intrathecal chemotherapy and whole brain radiotherapy (WBRT), showing fourteen months of disease-free survival at the time of this case report. A review of the available literature is also presented.

Keywords:
Hodgkin lymphoma
Primary lymphoma
Central nervous system
Brain neoplasm
Histology
Immunohistochemistry
Abbreviations:
HL
CNS
WBRT
CT
MRI
RS
EBV
Resumen

La afectación del sistema nervioso central (SNC) en pacientes con diagnóstico de linfoma de Hodgkin (LH) sistémico es una complicación muy poco frecuente, aunque bien definida. Sin embargo, el LH primario del SNC es una entidad extremadamente rara, cuyo diagnóstico precisa la identificación de un patrón morfológico e inmunohistoquímico específico, así como la afectación aislada del SNC.

Pese a contar con una casuística muy limitada (apenas una veintena de casos publicados en la literatura) la bibliografía disponible coincide en que el LH con afectación primaria y aislada del SNC, cuando es tratado con cirugía y tratamiento adyuvante (radioterapia±quimioterapia), parece tener un mejor pronóstico que aquellos casos en los que la afectación del SNC se produce en el contexto de un LH sistémico o en el contexto de un linfoma no Hodgkin.

En este artículo se presenta el caso de una mujer de 55 años con diagnóstico histopatológico de LH primario del SNC. La paciente fue sometida a una exéresis completa de la lesión y a tratamiento adyuvante con quimioterapia intratecal y radioterapia holocraneal, con una supervivencia libre de enfermedad hasta la fecha de 14 meses. Se presenta asimismo, la revisión de la literatura disponible.

Palabras clave:
Linfoma de Hodgkin
Linfoma primario
Sistema nervioso central
Tumor cerebral
Histología
Inmunohistoquímica

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