EXTENSIVE BONE MARROW INVOLVEMENT IN HODGKIN LYMPHOMA PATIENT

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EXTENSIVE BONE MARROW INVOLVEMENT IN HODGKIN LYMPHOMA PATIENT

Journal Title: Acta Facultatis Medicae Naissensis - Year 2014, Vol 31, Issue 4

Abstract

Bone marrow involvement is rare in patients with Hodgkin lymphoma (HL). Its incidence varies with respect to risk factors from 4% to 14%. Low risk patients do not need trephine biopsy according to some research. In the era of positron emission tomography/computed tomography (PET/CT) staging prior to therapy, the role of trephine biopsy as a part of staging procedures becomes debatable. Many institutions worldwide created their own guidelines in the application of trephine biopsy in staging of the (HL) patients. Our institution prefers performing trephine biopsy in all risk group patients, except those who underwent PET/CT staging before therapy and if no active bone sites were found. Most of our patients are staged using multislice computed tomography (MSCT) and we perform PET/CT in the follow up after completing the induction protocol. That is why we propose the trephine biopsy to the most of our patients. A Greek group of authors have derived a clinical prediction rule for the possibility of the bone marrow involvement, which is named the Z score (Zs), and if it is ≥10, patients are at high risk for bone marrow involvement. We present a case of a neglected, advanced (HL) patient, with the defined high risk for bone marrow involvement (Zs=25). He was clinically suspected to have affected bone marrow, which was later histologically confirmed. Unilateral trephine biopsy was performed.

Authors and Affiliations

Ivan Petković, Miljan Krstić, Slavica Stojnev, Ivica Pejčić, Svetislav Vrbić

Keywords

EP ID EP127003
DOI 10.2478/afmnai-2014-0032
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