Skin Involvement in Hodgkin's Disease

Untreated Hodgkin Lymphoma With Skin Infiltration and Satellite Skin Nodule in a 15-Year-Old Female Adolescent

A 15-year-old female adolescent presented with progressive neck swelling of 1 year duration and received 6 months of antituberculosis therapy in a local hospital with no benefit. After excision biopsy, she came to our institution. Examination showed 3 fungating, ulcerating neck masses and a chest wall skin nodule. Pathology confirmed Hodgkin lymphoma, stage IV BXE. FDG PET/CT showed a large neck tumor, a satellite skin nodule with local skin infiltration of tumor. She received 6 cycles of ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) chemotherapy and radiation therapy 2100 cGy. After chemotherapy, FDG PET/CT was negative. She is 2 years disease free.

Circulating tumor cells in Hodgkin's lymphoma - a review of the spread of HL tumor cells or their putative precursors by lymphatic and hematogenous means, and their prognostic significance

About 15% of patients diagnosed with classical Hodgkin's lymphoma (cHL) are considered high risk with unfavorable prognosis. The biology of the disease bears a direct relationship to its clinical course. However, some aspects of the disease are still being debated. Related topics include origin of neoplastic cells as circulating precursor versus germinal center B cell, and disease metastasis via hematogenous routes and the effect of HL circulation on relapse potential and further spread of the disease. The terminally differentiated giant neoplastic Hodgkin Reed-Sternberg (HRS) cells (HRSC) have limited proliferation and lack mobility. Therefore, they are unable to penetrate epithelium. Thus, the clinical aggressiveness of HRSCs that disseminate via both lymphatic and hematogenous may be determined by their molecular composition. This review discusses in detail the historical perspectives on scientific and clinical evidences of precursors of circulating HL cells and the prognostic importance of these circulating cells for predicting outcome.