Unusual bone marrow relapse of Hodgkin's disease with typical Pel-Ebstein fever.
We report the unusual case of a 43-year-old man with a diagnosis of clinical stage I A mixed cellularity Hodgkin's disease (HD), who relapsed 4 years after diagnosis with exclusive bone marrow involvement and a cyclic variation in body temperature typical of Pel-Ebstein fever. In the absence of clinical and laboratory signs of infection, a restaging of the lymphoma was performed. Total-body CT scan revealed no parenchymal or lymph node involvement, while a bone-marrow biopsy was positive for the presence of Reed-Sternberg cells. Therefore, the patient was started on combination chemotherapy, which promptly induced a normalization of the temperature curve. The presence of typical Pel-Ebstein fever, which is reported to be very rare, in association with bone marrow localization as the only site of relapse, suggests a relationship between these two rare manifestations of the disease.
Racchi
O
O
Division of Hematological Oncology, IST, Università di Genoa, Italy.
Rapezzi
D
D
Ferraris
A M
AM
Gaetani
G F
GF
D000328:Adult; D001853:Bone Marrow / Q000473:pathology; D005334:Fever; D006689:Hodgkin Disease / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D010507:Periodicity