Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids triggered by Hodgkin's lymphoma: A case report and brief literature review

Abstract

Key Clinical MessageWe presented a patient, diagnosed with lymphoma-associated CLIPPERS, 11 years after lymphoma treatment. Therefore, CLIPPERS may be paraneoplastic neurological syndrome of lymphoma, which needs to be considered in the follow-up of lymphoma cases.AbstractChronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a rare central nervous system disorder with a recent increase in incidence. There are few reports of lymphoma-associated CLIPPERS, although the relationship between these two diseases and the pathophysiology of CLIPPERS in general need further investigation. Here, we present a patient with a history of Hodgkin's lymphoma (HL) more than 10 years before the onset of CLIPPERS, in contrast to the majority of previously reported lymphoma-associated cases, and discuss the possibility that CLIPPERS is the paraneoplastic neurological syndrome of HL. This highlights the need to consider CLIPPERS as a differential diagnosis during follow-up of patients with a history of lymphoma. Coronal plane T1; multiple T1 low peppering curvilinear enhancing lesions (marked by arrows) in the brainstem and cerebellum suggesting chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) before treatment (a, e); reduction of enhancing lesions after initial treatment with corticosteroids (b, f) and plasmapheresis in the next hospitalization (c, g); disappearance of enhancing lesions at the 6-months follow-up visit (d, h)image