RT Journal Article
SR Electronic
T1 Hodgkin lymphoma presenting as alcohol-induced back pain
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e228440
DO 10.1136/bcr-2018-228440
VO 12
IS 11
A1 Lucy Ma
A1 Sanskriti Varma
A1 Ashwini Niranjan-Azadi
YR 2019
UL http://casereports.bmj.com/content/12/11/e228440.abstract
AB A 32-year-old Chinese man without significant medical history presented with a 2-month history of worsening lumbosacral back pain radiating to the groin and left lower extremity. He also described a shooting pain in the sciatic nerve distribution that began with and was exacerbated by alcohol consumption, a rare but known symptom of Hodgkin lymphoma (HL). On exam, an anterior chest wall mass was noted. Radiographic evaluation of an anterior mediastinal mass showed osseous erosion into the manubrium. MRI of the lumbar spine showed diffuse osseous disease of the lower thoracic and lumbar spine with extension into the right sacroiliac joint and S2 neural foramen without vertebral body collapse or stenosis. Tissue biopsy revealed nodular sclerosis HL, stage IVB IPS2. The patient was primary refractory to ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) therapy. Salvage ICE (ifosfamide, carboplatin, etoposide) chemotherapy was used and then followed by non-myeloablative haploidentical bone marrow transplant was performed on 5 March 2019.