Bone involvement in Hodgkin's disease is uncommon and seldom encountered at initial diagnosis. Seven cases with osseous involvement were identified from a series of 147 patients with Hodgkin's disease treated at Auckland Hospital from 1980 to 1988. Only one patient was found to have bone lesions at the time of initial presentation. Two patients had multiple lesions and 5 had a solitary lesion. Sites of involvement included the spine, pelvis, femur, humerus, ribs, sternum, scapula and base of skull. Six patients had nodular sclerosing histology and one had mixed cellularity disease. All 7 patients were treated with systemic chemotherapy for their advanced disease, and 5 patients needed local radiotherapy to sites of bone involvement. The radiation dosage schedules were individualized, ranging from 30 Gy to 40 Gy, using either a 6 MeV linear accelerator or cobalt machine. At the time of analysis of this study, 4 patients were in complete remission, 2 patients completed chemotherapy with good response and only 1 patient died of disseminated disease. The current review has demonstrated an encouraging response to treatment and good long term control. We believe that combined-modality therapy is effective in the treatment of osseous involvement in Hodgkin's disease.
Tuberculosis is one of the major health problems in India. Genitourinary tuberculosis, 20 % of all extrapulmonary tuberculosis, is the most common extrapulmonary system to be affected by this disease. Kidney is the most common genitourinary organ to be affected. A 50-year-old female presented with renal tuberculosis presenting as right upper thigh abscess, an uncommon presentation managed effectively by anti-tubercular therapy (ATT) and nephroureterectomy.
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