Primary multifocal osseous Hodgkin’s lymphoma with spinal involvement

A 40-year-old male presented with progressive backache; his workup revealed primary multifocal osseous Hodgkin’s lymphoma (PMOHL), which is a very rare primary presentation of Hodgkin’s lymphoma (HL). The common presenting symptoms include localized bone pain and tenderness with or without fever, weight loss or drenching night sweats. Given the rarity of the spine being affected in PMOHL and its symptoms overlapping with conditions like infectious or malignant causes, this case adds meaningful insight to existing literature so that delays in the diagnosis can be avoided. This case also signifies the need of repeat biopsy to prevent unnecessary delays and polypharmacy. Once diagnosis is made, adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) is still curative and cost-effective regimen in the cost constraint part of the world.