Therapeutic response of intracranial Hodgkin's disease documented by brain scanning

Craniocerebral involvement in lymphoma

Nine-hundred-eighty-nine patients with lymphoma were studied. Fifty-three cases (5.3%) had lymphomatous craniocerebral infiltration. The principal factors of risk for this complication were: advanced stage of the lymphoma (III or IV), diffuse histiocytic, diffuse poorly differentiated lymphocytic, or mixed cellularity lymphoma histological type, bone marrow involvement, and previous systemic chemotherapy. Thirty-two per cent of the cases of meningeal lymphomatous infiltration were asymptomatic and represented autopsy findings. CT-scan was an useful test to detect brain focal parenchymatous infiltration, as opposed to meningeal infiltration. Mean survival time in patients with lymphomatous meningeal infiltration was 4.3 months, following the combined use of systemic chemotherapy, radiation therapy and intrathecal methotrexate. Two cases had primary cerebral lymphoma, although without associated immunodeficiency. Twenty patients (2%) had intracranial hemorrhage, in clear relationship with platelet alterations. Fifteen patients (1.5%) had CNS infection, caused by common bacteria or opportunistic agents. In 7 cases, the diagnosis was made at autopsy. Thirty-six autopsies were performed. In 8 cases (22%), pathologic findings such as, demyelination, microcalcifications, coagulative necrosis, or gliosis, suggested complications from treatment.

Intracranial Hodgkin's disease. A report of 12 cases and review of the literature

Intracranial involvement by Hodgkin's disease is rare. Of the 30 previously reported cases, in many of which central nervous system (CNS) disease was documented postmortem, no associated risk factors have been elucidated, and response to treatment has been poor. This report cites 12 additional cases treated at the Stanford University Medical Center, five of whom have enjoyed prolonged freedom from intracranial relapse.

Intracerebral involvement in Hodgkin's disease: a report of 6 cases and review of the literature

Intracerebral involvement in Hodgkin's disease is an unusual complication. Only 28 cases have been reported. During the past twenty-four months, we have seen six patients with intracranial involvement. Five of the six patients were male and all had mixed cellular histology. We have found the cytocentrifuge examination of the cerebrospinal fluid, brain scan, angiography, and computerized axial tomography to be the most important diagnostic examinations. We feel that intracranial disease will be seen with increasing frequency as patients are living longer.

Scintigraphy in lymphomas and leukemia of the brain

Scintigraphy with 99mTc-pertechnetate made it possible to detect focal brain lesions in 4 patients with primary malignant lymphomas of the brain, one patient with CNS involvement with lymphatic immunoblastoma, one patient with Sézary syndrome (mycosis fungoides and T cell leukemia) and one child with a space occupying infiltration of myeloblastic leukemia. The scintigraphic results were verified by morphological data from biopsy or autopsy.