Bone marrow involvement as the initial presentation of hodgkin's lymphoma is undetectable by18F-fluorodeoxyglucose positron emission tomography/computed tomography

Chun Chi Lu, Cheng Yi Cheng, Tsu Yi Chao, Ching Liang Ho

Research output: Contribution to journalArticle


We report a 28-year-old male who presented with fever and bone pain without peripheral lymphadenopathy observed during initial physical examination. Subsequent bone marrow examination revealed the presence of Reed-Sternberg (RS) cells, which led to a diagnosis of mixed cellularity subtype of Hodgkin's lymphoma (HL). However, the initial 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scan did not show any detectable marrow or nodal lesions, with the exception of FDG uptake in an extranodal lesion over the right adrenal gland. Two weeks later, a 2-cm enlarged lymph node over the left submandibular region appeared. Excisional biopsy revealed HL. Mixed cellularity subtype of stage IV HL with initial bone marrow and unilateral adrenal gland involvement followed by submandibular lymphadenopathy was diagnosed, according to clinical, imaging, and histological manifestations. This patient received six cycles of chemotherapy with regimen of doxorubincin, bleomycin, vinblastine, and decabazine (ABVD). The subsequent FDG-PET/CT scan revealed complete remission after chemotherapy.

Original languageEnglish
Pages (from-to)209-212
Number of pages4
JournalJournal of Medical Sciences (Taiwan)
Issue number5
Publication statusPublished - 2008
Externally publishedYes



  • F-fluorodeoxyglucose positron emission tomography/computed tomography
  • Bone marrow
  • Hodgkin' lymphoma

ASJC Scopus subject areas

  • Medicine(all)

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