Childhood intrathoracic Hodgkin lymphoma with hypertrophic pulmonary osteoarthropathy: a case report and review of the literature.
Hypertrophic osteoarthropathy (HOA) is characterized by clubbing, periosteal new bone formation and polyarthritis. The pathogenesis of clubbing involves an increased expression of platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF) from the digitally lodged platelet clumps, which bypass the pulmonary capillary network as a result of various systemic disorders. Intrathoracic neoplasms are rare causes of HOA in children. We report here a 14-year-old boy with digital clubbing, who eventually received the diagnosis of intrathoracic Hodgkin lymphoma (HL) and HOA. Eight cases previously reported with these two diagnoses are reviewed to emphasize the prognostic significance of HOA in childhood HL.


CONCLUSIONS
Given the pathogenesis of clubbing and the prognostic significance of HOA, intrathoracic disease should be considered when HOA is detected in a child with a known or suspected malignant disease, and the occurrence of HOA during follow-up should alert the physicians for possible recurrence of the neoplastic disease or intrathoracic involvement.
Utine
Eda Gülen
EG
Department of Pediatrics, Division of Chest Diseases, Hacettepe University Sihhiye, 06100, Ankara, Turkey.
Yalçin
Bilgehan
B
Karnak
Ibrahim
I
Kale
Gülsev
G
Yalçin
Ebru
E
Doğru
Deniz
D
Kiper
Nural
N
Akyüz
Canan
C
Büyükpamukçu
Münevver
M
D000293:Adolescent; D001706:Biopsy; D003131:Combined Modality Therapy / Q000379:methods; D003937:Diagnosis, Differential; D018450:Disease Progression; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D008297:Male; D010005:Osteoarthropathy, Secondary Hypertrophic / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed