Leukoencephalopathy associated with Hodgkin's disease

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Abstract
The pathologic features which set this disease apart from other demyelinations are the specific changes in the astrocytes and oligodendroglial cells. Although large astrocytes can be found with such conditions as Schilder''s disease, they never assume such monstrous forms, nor are the oligodendroglial cells altered in the same manner. Moreover, the extension into the gray matter is quite uncharacteristic of ordinary diffuse sclerosis. The etiology is not known. Cytomegaly is seen in radiation damage and certain viral diseases. The effects of radiation or radiomimetic drugs have been considered, but in only a few of the cases known can such treatment and onset of the disease be linked, while several patients had no therapy whatsoever. Viral inclusions, despite some suggestive findings, have not been adequately demonstrated histologically, and no viral isolations have been attempted to date. The association with the lymphomas is striking but not invariable. It is tempting to try to relate the changes to some disorder of the reticulo-endothelial system, a theory which would be applicable not only with the lymphomas but also with tuberculosis and sarcoidosis. Cavanagh postulated on this basis a disorder of the immune mechanisms leading either to the formation of autoantibodies or facilitating the invasion by some, perhaps otherwise innocuous, virus or, because of the disordered reticuloendothelial metabolism, to a disturbance of the normal myelin metabolism. These, however, are speculations only, and the etiology of this illness is really as unknown as that of Schilder''s disease, multiple sclerosis, and carcinomatous neuropathy.

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