Benign proliferative lesions mimicking recurrence of Hodgkin's disease

Abstract

Salvage treatment in patients with recurrent Hodgkin's disease is more effective when tumor burden is minimal. That is why more intensive follow‐up strategies, including frequent imaging tests, have been recently developed for the detection of early relapse. However, as screening procedures become more sensitive, there is an increasing risk of false‐positive results, demonstrating nonmalignant proliferative disorders. We describe three young patients who had lymphocyte‐predominant or mixed‐cellularity Hodgkin's disease and were in clinical complete remission for 2.5–3 years after a combined treatment with chemotherapy and radiation. Imaging tests revealed new gallium‐avid lymphadenopathy in the chest in two cases. Pathologically enlarged pelvic lymph nodes were identified in another case, after a diagnosis of recurrent disease in axilla. Those findings were interpreted as relapse, and the patients underwent thoracotomy and laparotomy, respectively, for histologic confirmation. The results showed progressively transformed germinal centers and sarcoid‐like lesions, two benign proliferative disorders. When patients with Hodgkin's disease in remission show new lymphadenopathy, even with positive gallium scan, it seems mandatory to obtain tissue for histologic examination, even through invasive procedures such as laparotomy and thoracotomy, to avoid wrong diagnosis and unnecessary treatment. Med. Pediatr. Oncol. 28:187–190 © 1997 Wiley‐Liss, Inc.

Effectiveness of high dose chemoradiotherapy and autologous stem cell transplantation for patients with biopsy‐proven primary refractory Hodgkin's disease

“…Moreover, the inclusion of patients with unconfirmed pathology may result in the inclusion of patients with aggressive NHL, with a non‐malignant disorder (infection, or sarcoid‐like reactions) or patients with residual radiologic abnormalities but no active HD into a HDT programme. These other non‐HD entities are often strongly positive on gallium or positron emission tomography (PET) imaging; thereby making histologic confirmation even more imperative (Gargot et al , 1990; Epelbaum et al , 1997; Bakheet et al , 1998; Simsek et al , 2002).…”

Association d’une sarcoïdose pulmonaire, hépatite virale B et leucémie aigue myéloblastique

“…Cette association a longtemps été considéré comme fortuite. La prévalence de la sarcoïdose est également augmentée au cours des hémopathies malignes, notamment la maladie de Hodgkin (14%) et les lymphomes malins non Hodgkiniens (4 à 7%), plus rarement au cours du myélome et des leucémies aigues [ 1 ]. Il parait de plus en plus probable que la survenue de sarcoïdose maladie soit un événement de causes variées, encore mal définies, associant une prédisposition génétique et une exposition à des facteurs environnementaux spécifiques.…”

Delayed sarcoidosis onset mimicking mediastinal lymphoma recurrence after complete remission of diffuse large B cell lymphoma: A case report

“…In SLS, sarcoidosis and lymphoma may be concurrent, or sarcoidosis may precede lymphoma 2 . There have been few reports which have previously described the progression from lymphoma to sarcoidosis 2–7 …”