Primary multifocal osseous Hodgkin disease: a case report and review of the literature
Primary multifocal osseous Hodgkin disease: a case report and review of the literature
复制标题
DOI：
10.1007/s00432-004-0641-0
复制
发表时间：
2005-03-01
影响因子：
3.6
通讯作者：
Gosheger, G
中科院分区：
文献类型：
--
作者：
Gebert, C;Hardes, J;Gosheger, G
目的：霍奇金病（HD）通常累及淋巴系统的一个或多个部位。罕见的是，霍奇金病表现为不累及淋巴结的骨性病变。因此，骨HD的组织学诊断可能存在问题。我们提出了一个罕见的情况下，多灶性骨HD和审查的文献，特别强调治疗和预后。研究方法：骨髓炎和淋巴瘤是主要的鉴别诊断，只能通过斯滕贝格里德细胞的存在或免疫组化检查在组织学上排除。本病例报告一位21岁男性，在股骨近端和胫骨近端发生霍奇金淋巴瘤。结果：分期研究未发现其他肿瘤表现。根据安阿伯分类，本病例应为IV期疾病。尽管考虑到安阿伯分类预后不良，但患者在刮宫、局部放疗和全身化疗后4年无疾病证据。结论：回顾少数报告的病例，骨HD必须与全身性HD伴弥漫性骨髓受累和晚期疾病的骨转移相区别，因为它似乎具有更好的预后。
Purpose: Hodgkin disease (HD) typically involves the lymphatic system at one or more sites. Rarely, Hodgkin disease presents as an osseous lesion without involvement of lymph nodes. Therefore, the histologic diagnosis of osseous HD can be problematic. We present a rare case of multifocal osseous HD and a review the literature with special emphasis on treatment and prognosis. Methods: Osteomyelitis and lymphoma are the main differential diagnoses and can only be excluded histologically by the presence of Sternberg Reed cells or by immunohistochemical examinations. This case reports a 21-year old man with a Hodgkin lymphoma located at the proximal femur and the proximal tibia. Results: Staging studies revealed no other tumor manifestations. Regarding the Ann Arbor classification, the presented case should be a stage IV disease. The patient is without evidence of disease 4 years after curettage, local radiation therapy, and systemic chemotherapy despite the poor prognosis considering the Ann Arbor classification. Conclusion: Reviewing the few reported cases, osseous HD must be distinguished from systemic HD with diffuse bone marrow involvement and from osseous metastases in advanced stage of disease because it seems to have a better prognosis.