title: Clinically unsuspected Hodgkin's lymphoma diagnosed primarily from bone marrow trephine biopsy: report of six cases.
abstract: Bone marrow may be the initial or rarely the only site of involvement in Hodgkin's lymphoma. A high index of suspicion is required to pick up the histopathological changes of Hodgkin's lesions in the bone marrow like necrosis, presence of Reed-Sternberg cell or its variant in a polymorphic background infiltrate, focal fibrosis and myxoid change especially in the absence of classical clinical picture. Bone marrow with immunohistochemistry has a valuable role in the staging and in the diagnosis of primary medullary Hodgkin's lymphoma. B-symptoms may easily masquerade as an infectious process as in all our cases the patients had fever as a presenting feature, in four of them tuberculosis was suspected clinically and two had received antitubercular therapy elsewhere. We report six human immunodeficiency virus-negative patients diagnosed over a period of 5 years in which the initial diagnosis of Hodgkin's lymphoma was suggested from bone marrow histology.
authors.affiliation: Department of Hematology, AIIMS, New Delhi 110 029, India.
authors.forename: Rakhee
authors.initials: R
authors.lastname: Kar
authors.forename: Shyamali
authors.initials: S
authors.lastname: Dutta
authors.forename: Seema
authors.initials: S
authors.lastname: Tyagi
mesh_terms: D000293:Adolescent; D001853:Bone Marrow / Q000276:immunology / Q000473:pathology; D001856:Bone Marrow Examination / Q000379:methods; D002675:Child, Preschool; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D017730:Ki-1 Antigen / Q000378:metabolism; D016256:Lewis X Antigen / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D017730:Ki-1 Antigen; D016256:Lewis X Antigen