Hodgkin's Lymphoma with Leptomeningeal Involvement

A 31-year-old male patient with Hodgkin's lymphoma (HL) and leptomeningeal involvement presented to at Hematology Departments of Ataturk University. The patient developed dizziness, limb weakness, involuntary contractions of the hands and feet, incontinence, headache, fever, nausea, and vomiting following the first cycle of treatment with the ABVD protocol (adriamycin 25 mg m(-2), bleomycin 10 mg m(-2), vinblastin 6 mg m(-2), and dacarbazine 375 mg m(-2) on d 1 and 15 of a 28-d cycle). Magnetic resonance imaging (MRI) showed that there were regions with infiltration in particularly the thoracic vertebrae (T3, T4, T9, and T10-T12). In the lumbar region leptomeningeal involvement beginning at the end of the medulla spinalis that gave rise to a separation of nerves in the cauda equine was observed. Contrast agent uptake was observed, especially at the dural sac, with edema in the nerve roots.