원인 미상의 발열로 내원한 환자에서 육아종성 반응을 동반한 골수침범을 보인 호지킨 림프종

Abstract

A 74-year-old man was admitted to our hospital because of febrile and chilling sensation those lasted for a month. He also complained general weakness, poor oral intake, and weight loss. Multiple enlarged non-tender, rubbery lymph nodes were palpable at the left side of the neck. Bone marrow aspiration with trephine biopsy and cervical lymph node biopsy were performed. The bone marrow revealed small vague granulomas. The lymph node showed scattered Hodgkin cells and Reed-Sternberg cells. This patient's disease was manifested by fever of unknown origin. In the advanced stage, malignant lymphomas can be associated with granulomas in the bone marrow. Therefore, granuloma in the bone marrow could be an important diagnostic feature of Hodgkin lymphoma, and should be considered as a relevant differential diagnosis.