Hodgkin's disease

(Thomas Hodgkin, 1798 - 1866, English physician), a form of malignant lymphoma in which patients have lymphadenopathy and splenomegaly, anaemia and sometimes bone abnormalities. For a general description, see Hodgkins disease.

Bone involvement is not usually obvious at the time of clinical presentation and is more common in adults than in children. It may occur from haematogenous dissemination or direct spread from contiguous involved lymph nodes. The bones involved most commonly are those of the spine and pelvis and the ribs, femora and sternum. Patients with more aggressive forms of Hodgkin's disease also tend to have a higher frequency of bone involvement and of poorly defined or permeative bone destruction.

On radiographs the bone involvement may appear as osteosclerosis or osteolysis alone or in combination. The spine may reveal scalloping of the anterior surface of the vertebral body or sclerosis of the sternum. Diffuse sclerosis of the vertebral body (an ivory vertebral body) similar to that seen in other lymphomas and Pagets disease may also be noted. The osteolytic lesions are poorly defined and sometimes associated with periostitis.

DR