Bone involvement in Hodgkin's disease

Abstract

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.

Primary multifocal osseous Hodgkin disease: a case report and review of the literature

“…Most of the cases have been associated with synchronous lymph node involvement. Since 1927, only seven patients with primary solitary osseous HD [6,19,26,31,32,33] and five patients with primary multifocal osseous Hodgkin disease have been reported without lymphatic manifestations [13,16,29,31]. Two of these cases, which have been reported before 1944, presented limited clinical and radiographic evalu- ations.…”

Lymphoma of bone: a review of 140 patients

“…The disease occurs most frequently in adults but is occasionally found in children [11,17,19,23,25,29,34,36,37,38,51,52,54] where the tumors may be small and confined to bone or may be extensive with a large soft tissue mass [7,8,17,19,27], the lesions may be entirely asymptomatic or very painful and disabling, purely lytic on imaging th A. The lesion shows increased density, quite commonly seen in patients with Hodgkin's disease.…”

“…The appearance of lesions on X-ray, computed tomography and magnetic resonance imaging vary widely [8,15,19,21,35,36,46,47]. Some patients presented with tumors that were very small and subtle and difficult to define as a malignant tumor on the basis of the image (Figure 1).…”

“…Various causes, such as Epstein-Barr virus infection, genetic errors and immunologic abnormalities have been proposed, but to date there is no evidence to support any of these explanations and the disease is postulated to be a neoplasm of unknown cause [7]. Primary bone lesions in patients with Hodgkin's disease are considered very rare and most reports are those of a small number of patients [7][8][9][10][11][12][13][14][15]. Of some interest is the finding of CD15 and CD30 in the bone lesions upon immunohistological staining, but no evidence is presented to suggest a genetic error or familial transmission of the disorder [7].…”

Malignant tumors of the sternum in pediatric patients: report of two cases and literature review

“…Попытки сопоставить наши наблюдения с данными литературы оказались затруднитель-ными, прежде всего, не только из-за упоминания о первичных опухолевых поражениях грудины у детей как о крайне редких [2], но и из-за того, что при типичных для этой возрастной группы системных лимфопролиферативных заболевани-ях -неходжкинской лимфоме и лимфоме Ход-жкина [3][4][5] -поражение грудины крайне редко выступает как первично манифестирующий очаг. Вместе с тем нельзя не отметить, что в структу-ре злокачественных новообразований человека первичные опухоли грудной стенки составляют 0,2-2 % [6], а среди всех опухолей грудины зло-качественный характер имеют 85 % поражений, значительная часть из которых приходится имен-но на хондросаркому и злокачественные лимфо-мы [7][8][9].…”