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Case report
Hodgkin lymphoma presenting as alcohol-induced back pain
  1. Lucy Ma1,
  2. Sanskriti Varma2 and
  3. Ashwini Niranjan-Azadi3
  1. 1Uniformed Services University of the Health Sciences, F Edward Hebert School of Medicine, Bethesda, Maryland, USA
  2. 2Johns Hopkins School of Medicine, Baltimore, Maryland, USA
  3. 3Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to Dr Ashwini Niranjan-Azadi; aniranj1{at}


A 32-year-old Chinese man without significant medical history presented with a 2-month history of worsening lumbosacral back pain radiating to the groin and left lower extremity. He also described a shooting pain in the sciatic nerve distribution that began with and was exacerbated by alcohol consumption, a rare but known symptom of Hodgkin lymphoma (HL). On exam, an anterior chest wall mass was noted. Radiographic evaluation of an anterior mediastinal mass showed osseous erosion into the manubrium. MRI of the lumbar spine showed diffuse osseous disease of the lower thoracic and lumbar spine with extension into the right sacroiliac joint and S2 neural foramen without vertebral body collapse or stenosis. Tissue biopsy revealed nodular sclerosis HL, stage IVB IPS2. The patient was primary refractory to ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) therapy. Salvage ICE (ifosfamide, carboplatin, etoposide) chemotherapy was used and then followed by non-myeloablative haploidentical bone marrow transplant was performed on 5 March 2019.

  • oncology
  • haematology (incl blood transfusion)
  • back pain
  • musculoskeletal and joint disorders
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  • Contributors LM and SV contributed equally to this manuscript and share first authorship. LM and SV both drafted the manuscript, collected data and critically revised the documents to its final version. AN-A critically revised the documents to its final version. LM, SV and AN-A all approve the final manuscript for submission and publication.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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