Tang Fan, Min Li, Ye Yunxia, Tang Bo, Zhou Yong, Zhang Wenli, Tu Chongqi
Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, MA Department of Pathology, West China Hospital, Sichuan University, Chengdu, China Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Medicine (Baltimore). 2017 Sep;96(39):e8196. doi: 10.1097/MD.0000000000008196.
Classic Hodgkin lymphoma with pelvic involvement is a rare entity. Diagnosis and treatment for such an uncommon disease are challenging. Here we report a special case of classic Hodgkin lymphoma in pelvis.
A 20-year-old woman was admitted to our department due to left hip symptoms. The patient reported a history of drenching night sweats, low-grade fever, pruritic rash on the body, and an almost 15% weight loss during the previous 3 months.
Imaging studies revealed osteolytic destruction of the left hemi-pelvic with a huge soft-tissue mass. Open biopsy established the pathological diagnosis of classic Hodgkin lymphoma.
Considering the B symptom, bulky disease, and high risk of pathological fracture of the patient, we performed limb-salvage surgery and 6 cycles ABVD chemotherapy with 2 cycles before surgery.
Up to now, at the 3-year follow-up, there is no sign of disease relapse and metastasis. Besides, her limb function recovered well.
Based on this case and literature we reviewed, diagnoses for primary bone Hodgkin lymphoma should be cautious. For the treatment, chemotherapy was the main treatment option. Classic Hodgkin lymphoma patients seldom received tumor resection surgery, but for the special bone classic Hodgkin lymphoma individual with a huge tumor volume and high risk of pathological fracture in our study, limb-salvage surgery based on ABVD chemotherapy provided a satisfying clinical outcome.
累及盆腔的经典型霍奇金淋巴瘤是一种罕见的疾病。对这种罕见疾病的诊断和治疗具有挑战性。在此，我们报告一例盆腔经典型霍奇金淋巴瘤的特殊病例。
一名20岁女性因左髋部症状入院。患者报告在过去3个月中有盗汗、低热、全身瘙痒性皮疹病史，且体重减轻近15%。
影像学检查显示左半骨盆溶骨性破坏并伴有巨大软组织肿块。开放活检确诊为经典型霍奇金淋巴瘤。
考虑到患者存在B症状、大包块病变以及病理性骨折的高风险，我们实施了保肢手术，并在术前进行了2个周期、术后进行了6个周期的ABVD化疗。
截至目前，在3年的随访中，没有疾病复发和转移的迹象。此外，她的肢体功能恢复良好。
基于该病例以及我们回顾的文献，原发性骨霍奇金淋巴瘤的诊断应谨慎。对于治疗，化疗是主要的治疗选择。经典型霍奇金淋巴瘤患者很少接受肿瘤切除手术，但对于我们研究中肿瘤体积巨大且病理性骨折风险高的特殊骨经典型霍奇金淋巴瘤个体，基于ABVD化疗的保肢手术提供了令人满意的临床结果。
