# Primary multifocal osseous Hodgkin’s lymphoma with spinal involvement

## TL;DR

A rare case of primary multifocal osseous Hodgkin’s lymphoma affecting the spine is reported, highlighting diagnostic challenges and treatment options.

## Contribution

This case report adds to the limited literature on spinal involvement in PMOHL and emphasizes the importance of repeat biopsy for timely diagnosis.

## Key findings

- PMOHL presenting with spinal involvement is rare and can mimic infectious or malignant conditions.
- Repeat biopsy is recommended to avoid diagnostic delays and inappropriate treatment.
- ABVD chemotherapy remains an effective and affordable treatment for PMOHL in resource-limited settings.

## Abstract

A 40-year-old male presented with progressive backache; his workup revealed primary multifocal osseous Hodgkin’s lymphoma (PMOHL), which is a very rare primary presentation of Hodgkin’s lymphoma (HL). The common presenting symptoms include localized bone pain and tenderness with or without fever, weight loss or drenching night sweats. Given the rarity of the spine being affected in PMOHL and its symptoms overlapping with conditions like infectious or malignant causes, this case adds meaningful insight to existing literature so that delays in the diagnosis can be avoided. This case also signifies the need of repeat biopsy to prevent unnecessary delays and polypharmacy. Once diagnosis is made, adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) is still curative and cost-effective regimen in the cost constraint part of the world.