Majeed Aneela, Chan Onyee, Okolo Onyemaechi, Shponka Volodymyr, Georgescu Anca, Persky Daniel
Department of Infectious Diseases, University of Arizona, Banner University Medical Center, Tucson, Arizona, USA.
Department of Medicine, University of Arizona, Banner University Medical Center, Tucson, Arizona, USA.
Case Rep Oncol. 2017 Jun 20;10(2):542-547. doi: 10.1159/000474938. eCollection 2017 May-Aug.
Hodgkin lymphoma with symptomatic osseous involvement can have a similar presentation to osteomyelitis. Common findings in symptoms, laboratory workup, and imaging can make it very difficult to distinguish between the two diseases. Excisional biopsy should be pursued if fine-needle biopsy is equivocal and suspicion of lymphoma is high. We report a case of a 40-year-old man who presented with a history of marine animal sting on his neck and later developed erythema in the area, chest pain, constitutional symptoms, adenopathy, and imaging classic for sternal osteomyelitis. Fortunately, initial biopsy prompted the possibility of lymphoma, and further workup was initiated, which confirmed Hodgkin lymphoma. This case is a good reminder that malignancies and infections can share many common features, and keeping a broad differential diagnosis can be lifesaving. Proper staging and risk stratification of Hodgkin lymphoma help determine the optimal treatment.
有症状性骨受累的霍奇金淋巴瘤可能有与骨髓炎相似的表现。症状、实验室检查和影像学检查中的常见发现可能使区分这两种疾病非常困难。如果细针活检结果不明确且淋巴瘤怀疑度高，则应进行切除活检。我们报告一例40岁男性病例，该患者颈部有海洋动物蜇伤史，随后该区域出现红斑、胸痛、全身症状、淋巴结病以及典型的胸骨骨髓炎影像学表现。幸运的是，初始活检提示了淋巴瘤的可能性，并启动了进一步检查，最终确诊为霍奇金淋巴瘤。该病例很好地提醒我们，恶性肿瘤和感染可能有许多共同特征，保持广泛的鉴别诊断可能挽救生命。霍奇金淋巴瘤的正确分期和风险分层有助于确定最佳治疗方案。
