title: A case of Hodgkin lymphoma in a patient with a history of bone pain and an initial diagnosis of chronic osteomyelitis.
abstract: Hodgkin lymphoma (HL) is an uncommon monoclonal lymphoid malignancy consisting of 2 main entities: classical HL and nodular lymphocyte predominant. Hodgkin lymphoma usually presents with peripheral lymphadenopathies, while extranodal involvement is rare. Prevalent osseous presentation is rare and still misdiagnosed, despite improvements in diagnostic techniques. Here we report the case of a 30-year-old man with multifocal HL bone involvement initially misdiagnosed as chronic recurrent osteomyelitis. This case emphasizes the difficulties in the diagnosis of HL presenting with bone pain and with radiologic skeletal findings not specific for lymphoma. These patients often have diagnostic delays and misdiagnosis. Repeated investigations and clinical suspicion of unusual presentations may be helpful in order to establish a correct diagnosis and start an effective treatment in this highly curable disease.
authors.affiliation: 1 Lymphoma Unit, Oncology Institute of Southern Switzerland, Bellinzona - Switzerland.
authors.forename: Gaia
authors.initials: G
authors.lastname: Griguolo
authors.forename: Luca
authors.initials: L
authors.lastname: Mazzucchelli
authors.forename: Franco
authors.initials: F
authors.lastname: Cavalli
authors.forename: Luca
authors.initials: L
authors.lastname: Ceriani
authors.forename: Emanuele
authors.initials: E
authors.lastname: Zucca
authors.forename: Anastasios
authors.initials: A
authors.lastname: Stathis
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001706:Biopsy; D001761:Bleomycin / Q000008:administration & dosage; D050071:Bone Density Conservation Agents / Q000008:administration & dosage; D001853:Bone Marrow / Q000473:pathology*; D001859:Bone Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D002908:Chronic Disease; D003606:Dacarbazine / Q000008:administration & dosage; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004164:Diphosphonates / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006689:Hodgkin Disease / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D010006:Osteoblasts / Q000473:pathology; D010019:Osteomyelitis / Q000150:complications / Q000175:diagnosis; D010146:Pain / Q000209:etiology*; D010996:Pleural Effusion / Q000209:etiology; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals / Q000378:metabolism; D012074:Remission Induction; D012447:Sacrum / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure; D014747:Vinblastine / Q000008:administration & dosage
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D001761:Bleomycin; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin