Principle author

1.Dr.A.Sivaram, Postgraduate resident, Department of General Medicine, SMVMCH, Puducherry, sivamdacadCa Email.com, Ph:9003846001

Co authors

Dr.M.K.Uthayasankar MD(General Medicine ),
Professor and Unit Chief ,
Department of General Medicine,
SMVMCH, Puducherry
drmku2009gmail.cont,
Plc : 9443079829

Objective

45 year old male presented with the low back ache for 6 months along with difficulty in walking for 1 mohth,which progressed since 10 days,with no comorbidities, smoker and alcoholic for 15 years. General examination showed irutiple cervical non tender, non matted lymphadehopathy sized 4-5mm ,nervous system examination showed bilateral lower limb hypotonia with intact DTR,beevors sign positive, loss of abdominal and cremasteric reflex ,plantar extensor with band like sensation around hip with loss of sensation over perianal region features suggestive of extradural extramedullary compressive myelopathy at the spinal level of
Tl0. INVESTIGATIONS : Basic hematological investigations were normal. Chest Xray showed mass lesion in paravertebral region at the thoracic level D4 to D6.MRI showed mass compressing spinal canal at leve I of D7-9 ,D12-L I with multiple lymphadenopathy features s/o Lymphoma.Lymphnode biopsy revealed Hodgkin’s lymphoma.

DISC USSION : Only 5% of cases of Hodgkin’s lymphoma may develop spinal cord compression. In only 0.2% cases, cord compression is the initial presentation. Hodgkin’s lymphoma involving the epidural space is very responsive to radiation therapy and chemotherapy, with a good prognosis for both functional recovery (86%), complete response (61%) and long-term survival.

Keywords

Paraplegia , Hodgkins lymphoma, compressive myelopathy