Luo Wei, Zhang Fangjie, Sun Jinpeng, He Hongbo
Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China.
Oncol Lett. 2015 Feb;9(2):677-680. doi: 10.3892/ol.2014.2724. Epub 2014 Nov 20.
Hodgkin's lymphoma (HL) is one of the few adult malignancies that most frequently presents with a progressive, painless enlargement of the peripheral lymph nodes. A primary osseous presentation of HL, without lymph node involvement, is extremely rare. The present study describes a case of primary multifocal osseous HL in a 22-year-old female. The patient presented with pain in the lumbar-sacral-pelvic area and a prolonged fever. Pathological examination led to a diagnosis of primary multifocal osseous lymphoma, and the patient was subsequently prescribed a course of Adriamycin, bleomycin, vinblastine and dacarbazine (ABVD) chemotherapy. Following this, the patient recovered with no pain or fever, and computed tomography identified no further progression. The clinical, radiological and histological features of HL are similar to those of other medical conditions, such as tuberculosis and eosinophilic granuloma. Furthermore, in rare cases, HL may even occur in combination with multiple myeloma. This makes it difficult to diagnose the condition, which often leads to a delay in treatment. Clinicians should not ignore HL when it manifests in the unusual primary osseous form.
霍奇金淋巴瘤(HL)是少数几种在成人恶性肿瘤中最常表现为外周淋巴结进行性无痛性肿大的疾病之一。HL以原发性骨表现且无淋巴结受累极为罕见。本研究描述了一例22岁女性原发性多灶性骨HL病例。该患者表现为腰骶骨盆区域疼痛和长期发热。病理检查确诊为原发性多灶性骨淋巴瘤,随后患者接受了阿霉素、博来霉素、长春碱和达卡巴嗪(ABVD)化疗疗程。此后,患者康复,无疼痛或发热,计算机断层扫描显示无进一步进展。HL的临床、放射学和组织学特征与其他疾病如结核病和嗜酸性肉芽肿相似。此外,在罕见情况下,HL甚至可能与多发性骨髓瘤合并发生。这使得该病难以诊断,常常导致治疗延误。当HL以不常见的原发性骨形式出现时,临床医生不应忽视它。