Hodgkin lymphoma - spine

120 views535y Male10/9/2026

Clinical Presentation

Upper back pain for several months. No trauma. Now more acute. Raised ESR and WCC.

1Partial collapse of the T4 and T5 vertebral bodies with an associated a bilateral symmetrical paraspinal mass
2Altered signal in T3, T4 and T5 with diffuse vertebral body enhancement
3Discs spared.Severe collapse with at least 50% loss of vertebral body height of T4 and T5 with a resultant gibbus.Associated with the above is a symmetrical rind of contiguous enhancing pre-and paravertebral soft tissue as well as enhancing soft tissue extending into the epidural space with resultant severe narrowing of the central canal and partial compression of the cord.No signal change in the cord to imply oedema.The remainder of the spine is normal.Soft tissue name anterior mediastinum measuring up to 5 cm.Small bilateral pleural effusions.Cervical lymphadenopathy more pronounced on the left, the largest being a 2.5 cm left supraclavicular lymph node.Enhancing 1.5cm pleural based nodule in the posterior aspect of the left upper thoracic cavity
4Irregular 3.3cm soft tissue mass in the left supraclavicular fossa (correlating with the localizer of the MRI).Ultrasound guided core biopsy was undertaken
5CT chest3.2 cm left supraclavicular lymph node.Diffuse large volume mediastinal lymphadenopathy at multiple nodal stations
6The largest discrete node in the right paratracheal space measures 4.6 cm.Partial collapse of T4 and T5 vertebral bodies as well as lucency of the T3 vertebral body with an associated kyphosis
7Symmetrical rind of soft tissue at T4/T5 measuring up to 1.8 cm in depth.Pericardial effusion measuring up to 1.7 cm.Mottled sclerotic appearance of the mid sternum.Tiny bilateral pleural effusions and bibasal atelectasis.CT abdomen1.7 cm enhancing lesion in segment 7 of the liver
8The remainder of the solid organs are normal.Several upper left periaortic lymph nodes measure up to 1.5 cm
9Supraclavicular lymph node biopsy report.