Hodgkin's disease of the thoracic vertebrae

Abstract

Background Context: Hodgkin's disease rarely occurs in the spine, which is usually a

Definition of cortical bone involvement in the staging of newly diagnosed pediatric Hodgkin lymphoma: A report from the International Working Group on Staging Evaluation and Response Criteria Harmonization (SEARCH)

“…Histologic staining for evidence of HL in a biopsied lesion was required in seven of the studies, whereas one study required confirmation of bone histology concordant with a lymph node biopsy . In another report, plain film findings with increased radionucleotide tracer uptake on Tc‐99m bone scan or histologic examination met the criteria for involvement, but CT evidence alone was considered sufficient in three other papers . In an additional three reports, CT evidence required histopathologic confirmation from a biopsy, whereas one study used MRI findings alone .…”

“…36 In another report, plain film findings with increased radionucleotide tracer uptake on Tc-99m bone scan or histologic examination met the criteria for involvement, 27 but CT evidence alone was considered sufficient in three other papers. 11,13,37 In an additional three reports, CT evidence required histopathologic confirmation from a biopsy, 9,15,38 whereas one study used MRI findings alone. 39 The remainder of the reports used FDG-PET findings to determine cortical bone involve- 11 In that study, a diagnosis of cortical bone involvement was suspected based on CT scan findings with confirmatory testing by a bone scan, conventional radiographs, MRI, or a PET scan; biopsies were not performed.…”

“…An additional question remains as to whether multifocal cortical bone disease represents more advanced disease and should, therefore, be staged and treated accordingly. There are no guidelines regarding the use of chemotherapy versus radiotherapy or a combination of the two in cases of isolated or multifocal bony lesions . It does not appear that one treatment modality is superior to another or to a combination of chemotherapy and radiotherapy, as all the case reports reviewed reported favorable outcomes regardless of the treatment chosen.…”

“…The most frequently used regimen (n = 10) was adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD). 6,9,13,31,33,34,37,38 Ten patients received chemotherapy alone, 7,9,13,29,31,33,34,37,38,43 whereas six received combined modality treatment with chemotherapy and radiation. 6,13,15,32,33 One report did not mention the treatment used, nor did it comment on survival.…”

“…There are no guidelines regarding the use of chemotherapy versus radiotherapy or a combination of the two in cases of isolated or multifocal bony lesions. [32][33][34][35][36][37][38][39]43 It does not appear that one treatment modality is superior to another or to a combination of chemotherapy and radiotherapy, as all the case reports reviewed reported favorable outcomes regardless of the treatment chosen.…”