Long-term remission of central nervous system vasculitis after treatment of Hodgkin's lymphoma with chemotherapy plus rituximab

Central nervous system vasculitis is an uncommon disease resulting from inflammation and destruction of the blood vessels of the brain, spinal cord, and meninges, and it constitutes a challenging diagnosis. It is classified as primary when it is confined to the central nervous system. We present a previously healthy 40-year-old man admitted because of a left hemiparesis and one-week history of mild bilateral frontal headache usually in the late afternoon that was relieved by paracetamol. Blood and cerebrospinal fluid workup was normal. Brain imaging showed a right frontoparietal lesion, and an abdominal lymphadenopathy was detected on the abdominal computed tomography. The lymph node and brain lesion histopathologies were compatible with Hodgkin's lymphoma and granulomatous vasculitis, respectively. He was treated with chemotherapy and rituximab as maintenance treatment during 18 months and entered clinical and imaging remission for 33 months.