CENTRAL-NERVOUS-SYSTEM HODGKINS-DISEASE RELAPSING WITH EOSINOPHILIC PLEOCYTOSIS

Hodgkin's disease affecting the central nervous system is infrequent. Multiple lumbar punctures are sometimes required for cytological diagn osis. In this case fluoroscopy-guided cisternal puncture and routine l umbar punctures were used to obtain cerebrospinal fluid (CSF) samples for cytological analysis. Reed-Sternberg cells were observed on the CS F sample obtained through the cisternal puncture while none were seen in the samples obtained with routine lumbar punctures. Without cytolog y, the diagnosis of meningeal carcinomatosis remains elusive. In concl usion, cisternal punctures should be entertained early in the evaluati on for meningeal carcinomatosis, particularly if lumbar punctures have been unsuccessful.