CASE REPORT

Hodgkin's lymphoma initially presenting with polymyalgic symptoms: a case report

Authors

Mehmet Sahin¹, Guchan Alanoglu², Oguzhan Aksu³, Sevket Ercan Tunc¹, Nilgun Kapucuoglu⁴ and Mahmut Yener⁵

1. Division of Rheumatology, Department of Internal Medicine, Suleyman Demirel University School of Medicine, TR-32260 Isparta, Turkey
2. Division of Hematology, Department of Internal Medicine, Suleyman Demirel University School of Medicine, Isparta, Turkey
3. Department of Internal Medicine, Suleyman Demirel University School of Medicine, Isparta, Turkey
4. Department of Pathology, Suleyman Demirel University School of Medicine, Isparta, Turkey
5. Department of Physical Medicine and Rehabilitation, Suleyman Demirel University School of Medicine, Isparta, Turkey

Received:

17 October 2006

Accepted:

19 December 2006

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Abstract

The association of polymyalgic symptoms and lymphoma is a rare event whose pathogenesis remains to be clarified. Here, we describe a case of a 75-year old man with Hodgkin's lymphoma, who had presented with polymyalgic symptoms suggesting polymyalgia rheumatica. An intensive investigation with respect to malignancy was initially negative. Corticosteroid treatment was administered first and a dramatic clinical improvement was achieved. Four months later, when the corticosteroid treatment was tapered off, the initial manifestations reappeared. After the development of lymph node enlargement, the patient was diagnosed by lymph node biopsy as having Hodgkin's lymphoma. The lymphadenopathy and musculoskeletal manifestations all responded well to chemotherapy. Hodgkin's lymphoma should be considered in the differential diagnosis of PMR. These musculoskeletal syndromes should alert the physician to possible paraneoplastic manifestations of an evolving neoplasm.

Key words

Hodgkin's lymphoma - Paraneoplastic syndrome - Polymyalgia rheumatica