抄録
A case of Hodgkin's disease with bone marrow involvement and variegated haemophagocytosis in the terminal stage is reported.
A 47-year-old man was admitted because of high fever, perspiration and dry cough for the third time after CHOP therapy based on pathological diagnosis of Hodgkin's disease of mixed cellularity by cervical lymph node biopsy with clinical stage I-B on the first admission and VEMP therapy on the second admission with the progression of clinical stage to III-B.
Physical examination on the third admission revealed marked hepatomegaly with severe hepatic dysfunction, and the clinical stage was diagnosed as IV-B.
His clinical condition was temporarily improved by VEMP therapy, but pneumonia was induced by pancytopenia with the appearance of abnormal cells in the peripheral blood. Bone marrow aspiration just before death disclosed an infiltration of Hodgkin's cells or Reed-Sternberg's cells, and in addition, marked haemophagocytosis characteristic of this case, namely, active phagocytosis of erythroblasts, myelocytes, metamyelocytes, mature neutrophils and thrombocytes by mononuclear or polynuclear atypical macrophages.
This haemophagocytosis is reminiscent of malignant histiocytosis which is a malignancy of macrophage, and a macrophage origin of Hodgkin's cells or Reed-Sternberg's cells was suggested in this case.
