SKELETAL LESIONS IN HODGKIN'S DISEASE

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Abstract
Of 65 patients with proved Hodgkin''s disease, 17 showed skeletal involvement on the basis of X-ray findings. The lesions were osteoplastic, osteolytic, or periosteal, although 2 or even 3 of the above types could be shown in a single lesion. Post-mortem studies were made on 20 of the cases. The specimens of marrow studied were the usual specimens taken at autopsy either from the sternum or from a rib. Hodgkin''s granuloma was found in 11 of this group. It was hoped that studies of aspirated sternal marrow might show early evidence of skeletal involvement. Aspirates from 47 patients showed changes in the cellular pattern consisting of an increase in neutrophilic and eosinophilic myelocytes and in plasma cells. In 3 instances the left shift was so marked as to suggest a leukemoid reaction. In a few instances megakaryocytic hyperplasia was striking. In no case was tissue characteristic of Hodgkin''s granuloma, e.g., Reed-Sternberg or giant cells, found in the aspirated marrow. It is postulated that invlovement of the bone marrow occurs early in the course of Hodgkin''s disease with subsequent spread of the lesion from marrow to bone cortex.

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