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Uruguayan Medical Journal

ISSN: 1688-0390

Vol.26 - Nº 1 - Mar. 2010

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Hodgkin Lymphoma of bone

Rev Med Urug 2010; 26: 39-44
Full text (spanish) |  Full text (spanish) (New windows, pdf) | Abstract


Introduction: Hodgkin lymphoma of bone is unusual and the compression of the bone marrow is exceptional, requiring a high degree of suspicion in order to be detected.

Method: a clinical case of a 37-year-old male patient is presented. After months of back pain with constitutional symptoms, lower extremities paraparesis is installed. Upon assessment with X-rays, ultrasound scan and and magnetic resonance imaging, which reveal destruction and flattening of the lumbar vertebrae bodies, the patient undergoes surgery in order to have his back stabilized. Bone biopsy reveals inflammatory infiltration with non-specific fibrosis and the patient is treated with antibiotics, subsequently receiving antituberculosis treatment. During evolution, superficial and deep adenopathic conglomerates are evidenced, resulting in the diagnosis of Hodgkin lymphoma through axillary node biopsy. We conducted a bibliographic review of Hodgkin lymphoma of the bone, and its presentation as the compression of the bone marrow.

Results: the patient received combined radiotherapy and chemotherapy treatment , showing a good clinical evolution. The bone lesions are not seen in the X-rays, although the parathyroid tumors persist. Therefore he receives radiotherapy. Bone involvement in Hodgkin lymphoma might not be associated to a bad prognosis by itself, so involvement of the bone marrow in advanced stages of the disease must not be extrapolated.

Conclusion: bone lymphomas are unusual, although the disease's debut may imply bone involvement and evidence compression of the bone marrow.

Bone biopsy, if there is no suspicion of the disease, is informed as a non-specific inflammatory infiltration with traces of fibrosis, and it is in such case when we have to increase our suspicion of bone lymphoma. Treatment usually consists of combined radiotherapy and chemotherapy and has a good life and functional prognosis, since bone involvement does not constitute an independent predictive factor for a bad prognosis.