This case illustrates Hodgkin lymphoma presenting with spinal disease in an initially indolent fashion.  

TB spine was in the initial differential, especially in view of this being common in our institution and the patients laboratory results.

The case has multimodality imaging and the tissue diagnosis was acquired from image guided biopsy.

Learning point:   As the radiologist try to advise and if possible perform the safest and most pragmatic procedure to get a histological diagnosis for the patient.

This case could be used in a fellowship exam scenario.