Polyostotic Fibrous Dysplasia Mimicking Bone Involvement in Hodgkin Lymphoma: A Pediatric Case and Literature Review
- 24 July 2020
- journal article
- review article
- Published by S. Karger AG in Acta Haematologica
- Vol. 144 (2), 212-217
- https://doi.org/10.1159/000508261
Abstract
Bone involvement in Hodgkin lymphoma (HL) is rare. The differential diagnosis between HL bone localization and other malignant or benign skeletal diseases is challenging. We report the case of a girl affected by classic HL, initially staged IVA because of supradiaphragmatic lymph nodes and skeletal involvement. After 6 ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) cycles, positron emission tomography (PET) showed a complete metabolic response of the nodal localizations and a persistent, high metabolic activity of bone lesions. Salvage treatment followed by autologous stem cell transplant was carried out. After the transplant, the bone lesions maintained a high metabolic activity at PET. A targeted bone biopsy led to the diagnosis of a fibrous dysplasia excluding the presence of HL. To our knowledge, the concomitant presence of HL and fibrous dysplasia has not been previously reported. An in-depth evaluation of disease response to frontline treatment with a biopsy of the PET-hypercaptant bone lesions could have avoided overtreatment in this patient.Keywords
This publication has 19 references indexed in Scilit:
- Fibrous Dysplasia Mimicking Bone Metastasis on Both Bone Scintigraphy and 18F-FDG PET-CT: Diagnostic Dilemma in a Patient with Breast CancerNuclear Medicine and Molecular Imaging, 2012
- Clinical guidelines for the management of craniofacial fibrous dysplasiaOrphanet Journal of Rare Diseases, 2012
- Fibrous dysplasia of bone: a clinicopathologic reviewPathology and Laboratory Medicine International, 2011
- F-18 FDG PET-positive Fibrous Dysplasia in a Patient with Intestinal Non-Hodgkin's LymphomaCancer Research and Treatment, 2009
- Intensity of FDG Uptake Is Not EverythingClinical Nuclear Medicine, 2008
- Primary multifocal osseous Hodgkin's lymphomaWorld Journal of Surgical Oncology, 2008
- Natural history and treatment of fibrous dysplasia of bone: a multicenter clinicopathologic study promoted by the European Pediatric Orthopaedic SocietyJournal of Pediatric Orthopaedics B, 2003
- Extranodal Hodgkin Disease: Spectrum of DiseaseRadioGraphics, 2001
- Fibrous dysplasia: MR imaging characteristics with radiopathologic correlation.American Journal of Roentgenology, 1996
- Fluorine-18 deoxyglucose and false-positive results: a major problem in the diagnostics of oncological patientsEuropean Journal of Nuclear Medicine and Molecular Imaging, 1996