Indian Journal of Pathology and Microbiology
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Year : 2008  |  Volume : 51  |  Issue : 2  |  Page : 186-189

Clinically unsuspected Hodgkin's lymphoma diagnosed primarily from bone marrow trephine biopsy: Report of six cases

Department of Hematology, AIIMS, New Delhi 110 029, India

Correspondence Address:
Seema Tyagi
Department of Hematology, AIIMS, New Delhi 110 029
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0377-4929.41675

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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.

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