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RSNA Education Exhibits: Ali Guermazi, Pauline Brice, Eric de Kerviler, Christophe Fermé, Christophe Hennequin, Véronique Meignin, and Jacques Frija Extranodal Hodgkin Disease: Spectrum of Disease Radiographics 2001; 21: 161-179 [Abstract] [Full text] [PDF]

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Primary Hodgkin Disease of Bone

Diana M. Veillon, MD, John J. Ward, MD and James D. Cotelingam, MD   (6 June 2002)

Primary Hodgkin Disease of Bone 6 June 2002
Diana M. Veillon, MD, Radiologist Louisiana State University Health Sciences Center- Shreveport, LA, John J. Ward, MD and James D. Cotelingam, MD Send letter to journal: Re: Primary Hodgkin Disease of Bone dveill{at}lsuhsc.edu Diana M. Veillon, MD, et al.	We read with interest the article by Guermazi et al (1) in the January-February 2001 issue of RadioGraphics. The article provided an excellent summary of the spectrum of extranodal Hodgkin disease, with emphasis on the radiologic findings. Of particular interest was the comment by the authors that "primary bone Hodgkin disease probably does not exist." We recently encountered such a case. The patient, an 82-year-old man, presented with a history of syncopal episodes and leg pain and was found to have a lytic lesion in the left fibula. Radiologic studies, including radiography and magnetic resonance imaging, revealed a radiolucent lesion in the proximal third of the left fibula with cortical erosion and soft-tissue extension. The tumor measured approximately 8.0 cm in greatest dimension. An open biopsy was performed and a histopathologic diagnosis of Hodgkin disease made. Reed-Sternberg cells were positive for CD15 and CD30 at immunostaining, and a fibrous matrix and reactive component of CD3 positive T lymphocytes were interspersed. The diagnosis was confirmed by the orthopedic and hematology departments of the Armed Forces Institute of Pathology. A complete staging work-up was performed, including bilateral bone marrow biopsies, which were negative for disease. Radiologic studies, including a positron emission tomography scan, confirmed the single fibular lesion and revealed no other evidence of disease. A complete description of this patient, including treatment and clinical follow-up, is being prepared for a full-length publication. Reference 1. Guermazi A, Brice P, de Kerviler E, et al. Extranodal Hodgkin disease: spectrum of disease. RadioGraphics 2001; 21:161-179.