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Neurologic Manifestations of Hodgkin's Disease: Intracerebral Hodgkin's Granuloma

Neurologic Manifestations of Hodgkin's Disease: Intracerebral Hodgkin's Granuloma Abstract IT is rare for intracerebral Hodgkin's disease to involve cranial nerves, particularly the optic nerves and optic chiasm. Virtually all reported cases of intracerebral Hodgkin's disease initially involved the floor of the cranial cavity and overlying meninges, with secondary extension to cranial nerves and brain. The patient described here with generalized Hodgkin's disease appears unique because the Hodgkin's granuloma originated in the hypothalamus and extended to the optic chiasm and cranial nerves. Clinical features included diabetes insipidus, hallucinations, and peripheral neuropathy. The systemic lesions spared many of the organs usually affected and involved other organs which are usually spared. Report of a Case This 23-year-old woman had been well until July 1964 when she developed a superior vena cava syndrome. Thoracotomy was performed at another hospital, with subtotal resection of an anterior superior mediastinal tumor, diagnosed as carcinoma of the thymus. Cobalt irradiation to the mediastinum and neck References 1. Jackson, H., and Parker, F., Jr.: Hodgkin's Disease and Allied Disorders , New York: Oxford University Press, 1947. 2. Richter, M.N.: " The Spleen, Lymph Nodes, and Reticuloendothelial System ," in Anderson, W.A.D. (ed.): Pathology , St. Louis: C. V. Mosby Company, 1966, pp 1034-1039. 3. Morehead, R.P.: Human Pathology , New York: McGraw-Hill Book Company, 1965, pp 251-252. 4. Lukes, R.J.; Butler, J.J.; and Hickes, E.B.: Natural History of Hodgkin's Disease as Related to Its Pathologic Picture , Cancer 19:317-344, 1966.Crossref 5. Geller, W., and Lacher, M.J.: Hodgkin's Disease , Med Clin N Amer 50:819-832, 1966. 6. Jackson, H., and Parker, F., Jr.: Hodgkin's Disease: V. Involvement of Certain Other Organs , New Eng J Med 233:369-373, 1945.Crossref 7. Sparling, H.J., Jr.; Adams, R.D.; and Parker, F., Jr.: Involvement of the Nervous System by Malignant Lymphoma , Medicine 26:285, 1947.Crossref 8. Sparling, H.J., Jr., and Adams, R.D.: Primary Hodgkin's Sarcoma of the Brain , Arch Path 42:338, 1946. 9. John, H.T., and Nabarro, J.D.N.: Intracranial Manifestations of Malignant Lymphoma , Brit J Cancer 9:386, 1955.Crossref 10. Fein, S.B., and Newell, V.A.: Cerebral Hodgkin's Disease: Case Report of Hodgkin's Granuloma With Cerebral Invasion , Amer J Med 17:291, 1954.Crossref 11. Gray, R.C., et al: Hodgkin's Disease of the Central Nervous System , Int Clin 4:230, 1941. 12. Lascelles, R.G., and Burston, J.: Hodgkin's Disease Presenting With Symptoms of Cranial Nerve Involvement , Arch Neurol 7:359, 1962.Crossref 13. Martin, H.E., and Courville, C.B.: Hodgkin's Disease With Involvement of the Cranial Dura Mater , Bull Los Angeles Neurol Soc 1:145, 1936. 14. Winkelman, N.W., and Moore, M.T.: Lymphogranulomatosis (Hodgkin's Disease) of the Nervous System , Arch Neurol Psychiat 45:304, 1941.Crossref 15. Kohut, H.: Unusual Involvement of Nervous System in Generalized Lymphoblastoma , J Nerv Ment Dis 103:9, 1946.Crossref 16. Ginsburg, S.: Lymphosarcoma and Hodgkin's Disease: Biologic Characteristics , Ann Intern Med 39:571, 1927.Crossref 17. Denny-Brown, D., and Foley, J.M.: Clinical Pathologic Conference , Neurology 3:615, 1953.Crossref 18. Davison, cited by Winkelman, N.W., and Moore, M.T.: Lymphogranulomatosis (Hodgkin's Disease) of the Nervous System , Arch Neurol Psychiat 45:318, 1941. 19. Williams, H.M., et al: Neurological Complications of Lymphomas and Leukemias , Springfield, Ill: Charles C Thomas, Publisher, 1959. 20. Berkman, J.; Netsky, M.; and Zimmerman, H.M.: Annual Meeting June 11, 1950, Case Discussion , J Neuropath Exp Neurol 10:100, 1951. 21. Troland, C.E.; Sahyoun, P.F.; and Mandeville, F.B.: Primary Mesenchymal Tumors of Brain , J Neuropath Exp Neurol 9:322, 1950.Crossref 22. Schricker, J.L., and Smith, D.E.: Primary Intracerebral Hodgkin's Disease , Cancer 8:629, 1955.Crossref 23. Litvak, J.; Leder, M.M.; and Kauvar, A.J.: Hodgkin's Disease Involving Optic Nerve and Brain , J Neurosurg 21:798, 1964.Crossref 24. Ljungdahl, L.; Strang, R.R.; and Tovi, D.: Intracerebral Hodgkin's Granuloma: Report of a Case and Review of the Literature , Neurochirugia 8:113, 1965. 25. Kaufman, G.: Hodgkin's Disease Involving the Central Nervous System , Arch Neurol 13:555, 1965.Crossref 26. Verda, D.J.: Malignant Lymphomas of the Spinal Epidural Space , Surg Clin N Amer 24:1228, 1944. 27. Croft, P.B., and Wilkinson, M.: " The Incidence of Carcinomatous Neuromyopathy With Special Reference to Lung and Breast Carcinoma ," in Brain, R., and Norris, F., Jr. (eds.): The Remote Effects of Cancer on the Nervous System , New York: Grune & Stratton, 1965, pp 44-54. 28. Fisher, C.; Ingram, W.R.; and Ranson, S.W.: Diabetes Insipidus and the Neurohormonal Control of Water Balance: A Contribution to the Structure and Function of the Hypothalamo-Hypophyseal System , Ann Arbor, Mich: Edwards Brothers, 1938. 29. Schneider, R.C.; Crosby, E.C.; and Farhat, S.M.: Extratemporal Lesions Triggering the Temporal-Lobe Syndrome: The Role of Association Bundles , J Neurosurg 22:246-263, 1965.Crossref 30. Schneider, R.C., et al: Temporal or Occipital Lobe Hallucinations Triggered From Frontal Lobe Lesions , Neurology 11:172-179, 1961.Crossref 31. Samuel, V.N.: Visual Hallucinations in Cerebral Lesions: A Case Report , Henry Ford Hosp Med Bull 9:391-397, 1961. 32. Cavanaugh, J.B., et al: Cerebral Demyelination Associated With Disorders of the Reticuloen-dothelial System , Lancet 2:524, 1959.Crossref 33. Lloyd, O.C., and Urich, H.: Acute Disseminated Demyelination of the Brain Associated With Lymphosarcoma , Lancet 2:529, 1959.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Neurologic Manifestations of Hodgkin's Disease: Intracerebral Hodgkin's Granuloma

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References (35)

Publisher
American Medical Association
Copyright
Copyright © 1967 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1967.00470280095011
Publisher site
See Article on Publisher Site

Abstract

Abstract IT is rare for intracerebral Hodgkin's disease to involve cranial nerves, particularly the optic nerves and optic chiasm. Virtually all reported cases of intracerebral Hodgkin's disease initially involved the floor of the cranial cavity and overlying meninges, with secondary extension to cranial nerves and brain. The patient described here with generalized Hodgkin's disease appears unique because the Hodgkin's granuloma originated in the hypothalamus and extended to the optic chiasm and cranial nerves. Clinical features included diabetes insipidus, hallucinations, and peripheral neuropathy. The systemic lesions spared many of the organs usually affected and involved other organs which are usually spared. Report of a Case This 23-year-old woman had been well until July 1964 when she developed a superior vena cava syndrome. Thoracotomy was performed at another hospital, with subtotal resection of an anterior superior mediastinal tumor, diagnosed as carcinoma of the thymus. Cobalt irradiation to the mediastinum and neck References 1. Jackson, H., and Parker, F., Jr.: Hodgkin's Disease and Allied Disorders , New York: Oxford University Press, 1947. 2. Richter, M.N.: " The Spleen, Lymph Nodes, and Reticuloendothelial System ," in Anderson, W.A.D. (ed.): Pathology , St. Louis: C. V. Mosby Company, 1966, pp 1034-1039. 3. Morehead, R.P.: Human Pathology , New York: McGraw-Hill Book Company, 1965, pp 251-252. 4. Lukes, R.J.; Butler, J.J.; and Hickes, E.B.: Natural History of Hodgkin's Disease as Related to Its Pathologic Picture , Cancer 19:317-344, 1966.Crossref 5. Geller, W., and Lacher, M.J.: Hodgkin's Disease , Med Clin N Amer 50:819-832, 1966. 6. Jackson, H., and Parker, F., Jr.: Hodgkin's Disease: V. Involvement of Certain Other Organs , New Eng J Med 233:369-373, 1945.Crossref 7. Sparling, H.J., Jr.; Adams, R.D.; and Parker, F., Jr.: Involvement of the Nervous System by Malignant Lymphoma , Medicine 26:285, 1947.Crossref 8. Sparling, H.J., Jr., and Adams, R.D.: Primary Hodgkin's Sarcoma of the Brain , Arch Path 42:338, 1946. 9. John, H.T., and Nabarro, J.D.N.: Intracranial Manifestations of Malignant Lymphoma , Brit J Cancer 9:386, 1955.Crossref 10. Fein, S.B., and Newell, V.A.: Cerebral Hodgkin's Disease: Case Report of Hodgkin's Granuloma With Cerebral Invasion , Amer J Med 17:291, 1954.Crossref 11. Gray, R.C., et al: Hodgkin's Disease of the Central Nervous System , Int Clin 4:230, 1941. 12. Lascelles, R.G., and Burston, J.: Hodgkin's Disease Presenting With Symptoms of Cranial Nerve Involvement , Arch Neurol 7:359, 1962.Crossref 13. Martin, H.E., and Courville, C.B.: Hodgkin's Disease With Involvement of the Cranial Dura Mater , Bull Los Angeles Neurol Soc 1:145, 1936. 14. Winkelman, N.W., and Moore, M.T.: Lymphogranulomatosis (Hodgkin's Disease) of the Nervous System , Arch Neurol Psychiat 45:304, 1941.Crossref 15. Kohut, H.: Unusual Involvement of Nervous System in Generalized Lymphoblastoma , J Nerv Ment Dis 103:9, 1946.Crossref 16. Ginsburg, S.: Lymphosarcoma and Hodgkin's Disease: Biologic Characteristics , Ann Intern Med 39:571, 1927.Crossref 17. Denny-Brown, D., and Foley, J.M.: Clinical Pathologic Conference , Neurology 3:615, 1953.Crossref 18. Davison, cited by Winkelman, N.W., and Moore, M.T.: Lymphogranulomatosis (Hodgkin's Disease) of the Nervous System , Arch Neurol Psychiat 45:318, 1941. 19. Williams, H.M., et al: Neurological Complications of Lymphomas and Leukemias , Springfield, Ill: Charles C Thomas, Publisher, 1959. 20. Berkman, J.; Netsky, M.; and Zimmerman, H.M.: Annual Meeting June 11, 1950, Case Discussion , J Neuropath Exp Neurol 10:100, 1951. 21. Troland, C.E.; Sahyoun, P.F.; and Mandeville, F.B.: Primary Mesenchymal Tumors of Brain , J Neuropath Exp Neurol 9:322, 1950.Crossref 22. Schricker, J.L., and Smith, D.E.: Primary Intracerebral Hodgkin's Disease , Cancer 8:629, 1955.Crossref 23. Litvak, J.; Leder, M.M.; and Kauvar, A.J.: Hodgkin's Disease Involving Optic Nerve and Brain , J Neurosurg 21:798, 1964.Crossref 24. Ljungdahl, L.; Strang, R.R.; and Tovi, D.: Intracerebral Hodgkin's Granuloma: Report of a Case and Review of the Literature , Neurochirugia 8:113, 1965. 25. Kaufman, G.: Hodgkin's Disease Involving the Central Nervous System , Arch Neurol 13:555, 1965.Crossref 26. Verda, D.J.: Malignant Lymphomas of the Spinal Epidural Space , Surg Clin N Amer 24:1228, 1944. 27. Croft, P.B., and Wilkinson, M.: " The Incidence of Carcinomatous Neuromyopathy With Special Reference to Lung and Breast Carcinoma ," in Brain, R., and Norris, F., Jr. (eds.): The Remote Effects of Cancer on the Nervous System , New York: Grune & Stratton, 1965, pp 44-54. 28. Fisher, C.; Ingram, W.R.; and Ranson, S.W.: Diabetes Insipidus and the Neurohormonal Control of Water Balance: A Contribution to the Structure and Function of the Hypothalamo-Hypophyseal System , Ann Arbor, Mich: Edwards Brothers, 1938. 29. Schneider, R.C.; Crosby, E.C.; and Farhat, S.M.: Extratemporal Lesions Triggering the Temporal-Lobe Syndrome: The Role of Association Bundles , J Neurosurg 22:246-263, 1965.Crossref 30. Schneider, R.C., et al: Temporal or Occipital Lobe Hallucinations Triggered From Frontal Lobe Lesions , Neurology 11:172-179, 1961.Crossref 31. Samuel, V.N.: Visual Hallucinations in Cerebral Lesions: A Case Report , Henry Ford Hosp Med Bull 9:391-397, 1961. 32. Cavanaugh, J.B., et al: Cerebral Demyelination Associated With Disorders of the Reticuloen-dothelial System , Lancet 2:524, 1959.Crossref 33. Lloyd, O.C., and Urich, H.: Acute Disseminated Demyelination of the Brain Associated With Lymphosarcoma , Lancet 2:529, 1959.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Oct 1, 1967

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