Breibach Florence, Julian Anne, Laurent Camille, Anglade Eric, Constantin Arnaud, Sans Nicolas, Tricoire Jean-Louis, Brousset Pierre, Delisle Marie-Bernadette, Gomez-Brouchet Anne
Centre Hospitalier Universitaire de Purpan, Anatomie et Cytologie Pathologiques, Place du Docteur Baylac, Toulouse, 31059, France.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.08.2008.0696. Epub 2009 May 25.
Hodgkin lymphoma typically presents as a nodal lesion and infrequently involves extra nodal sites. Although cases of primary extra-nodal Hodgkin lymphoma have been reported previously, the reality of the primitive nature of the disease was difficult to authenticate with traditional high resolution imaging techniques, such as computed tomography or magnetic resonance imaging, because they cannot evaluate the spread of the disease throughout the whole body. We report here a case of primary osseous Hodgkin lymphoma, regarded as stage I extranodal IE thanks to the important contribution of a new imaging technique, the 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/ computed tomography (18F-FDG-PET/CT). PET enables systemic Hodgkin lymphoma with secondary bone invasion to be distinguished from primitive osseous Hodgkin lymphoma. This technique is highly specific in demonstrating the isolated osseous localisation of the tumour and should be recommended in all patients with putative osseous lymphoma.
霍奇金淋巴瘤通常表现为淋巴结病变,很少累及结外部位。尽管先前已有原发性结外霍奇金淋巴瘤的病例报道,但由于传统的高分辨率成像技术,如计算机断层扫描或磁共振成像,无法评估疾病在全身的扩散情况,因此难以用这些技术证实该疾病的原始性质。我们在此报告一例原发性骨霍奇金淋巴瘤病例,由于一种新的成像技术——2-[18F]-氟-2-脱氧-D-葡萄糖正电子发射断层扫描/计算机断层扫描(18F-FDG-PET/CT)的重要作用,该病例被视为I期结外IE期。PET能够将继发性骨侵犯的系统性霍奇金淋巴瘤与原发性骨霍奇金淋巴瘤区分开来。这项技术在显示肿瘤的孤立骨定位方面具有高度特异性,对于所有疑似骨淋巴瘤的患者都应推荐使用。