Bone involvement in Hodgkin's disease

Abstract

Eighteen patients with osseous involvement were identified from a series of 124 consecutive patients treated with combined-modality therapy with advanced-stage or relapsing Hodgkin's disease. Multiple lesions were seen as frequently as were solitary lesions. Nodular sclerosing histology was as prevalent as mixed cellularity disease. However, those five cases initially diagnosed at protocol entry were predominantly mixed cellularity (80%) with multiple lesions (80%). Sites of involvement included: the spine, 24; pelvis, 8; ribs, 4; femur, 3; skull, 1; and shoulder 1. Actuarial survival for these patients was 84% at nine years. Only three patients were induction failures and no patient has had a relapse. Patients with bone lesions had favorable responses to combined-modality therapy.

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

“…In a study by Newcomer et al 24% of the lesions in HD were lytic, 20% were sclerotic, and 15% were mixed. The remaining 41% were unclassifiable [30]. In another study, 75% of the lesions were lytic, 15% sclerotic, and 5% were mixed.…”

“…Primary osseous Hodgkin disease must be distinguished from systemic HD with diffuse bone marrow involvement and from osseous metastases in advanced stage of disease, which occur in approximately 10-20% of cases [3,9,10,12,14,17,20,21,24,27,30,32]. Primary osseous HD has been reported in approximately 25 patients in the literature.…”

“…In late stage HD, osseous localizations have been described in 10-20% of cases [3,10,17,20,24,30], with less then 2% of cases showing skeletal lesions at the time of initial presentation. To our knowledge multifocal primary osseous HD without lymphatic manifestations has been reported only in five cases [13,16,29,31].…”

Osseous involvement in pediatric Hodgkin’s lymphoma

“…1 Pediatric osseous HL has not been studied exclusively in the chemotherapy era. Skeletal involvement in our experience was observed in 4.5% (3/66) of pediatric (≤18 yr) HL patients from June 2003-December 2006.…”

Lymphoma of bone: a review of 140 patients

“…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].…”