Hodgkin's Disease (Rib and Mediastinal Involvement)

Brief Discussion

Rib Lesions
 - Rib tumor
    Primary
        Malignancy: chondrosarcoma, plasmacytoma, lymphoma, osteosarcoma, MFH
        Benign: osteochondroma, enchondroma, osteoblastoma, osteoid osteoma, chondroblastoma, hemangioma
        Metastasis, direct invasion
- Infectious disease
    Osteomyelitis & abscess; fungal, tuberculosis, actinomycosis, other bacteria
- Others
    Fibrous dysplasia, Langerhans cell histiocytosis, Paget disease, renal osteodystrophy, hemoglobinopathies-
- Rib lesion 25/1034 (Chest CT readings for 3 months in Severance hospital)
    Lung cancer – 9 (pancoast tumor 3)
    Metastasis – 9 (breast ca 4, HCC 2, RCC 1, ovary cancer 1, unknown 1)
    Myeloma – 4
    Lymphoma – 2
    Benign – 1 (osteochondroma)

Skeletal Involvement of Hodgkin's Disease
- 10-25% of cases of HD
- infrequent at the time of clinical presentation
- more common in adult>child
- Pain is the most common symptom
- hematogenous or direct spread from LN
- Prognosis : depends on histologic type
- common site: spine, pelvis, rib, femur, sternum, scapula
- multiple lesion (2/3) > solitary form
- Osteolytic (75%), Osteosclerotic (15%), mixed (10%)
* diffuse sclerosis of vertebral body ( ivory vertebra ) : similar skeletal metastasis, Paget’s disease

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