[Diagnostic usefulness of FDG-PET/CT in multiple primary osseous Hodgkin lymphoma]

A 66-year-old man presented with a six-month history of periodic fever. A CT scan of the chest and abdomen performed at another hospital one month before admission disclosed no evidence of inflammation or tumor, and at admission he had no symptoms other than the periodic fever. FDG-PET/CT demonstrated increased FDG uptake in multiple vertebrae, ribs, scapulae, pelvis, and femurs. A core needle biopsy of the vertebra showing increased FDG uptake was performed, and he was diagnosed with primary osseous Hodgkin lymphoma. ABVD therapy was begun and the fever resolved immediately. After 6 cycles of ABVD, he achieved complete remission and has maintained remission for five years since diagnosis. Primary osseous Hodgkin lymphoma is rare and its lack of distinguishing clinical and radiological features makes it difficult to achieve an early differential diagnosis. FDG-PET/CT is a useful tool for detecting tumors when periodic fever suggests the possibility of malignant disease but when specific symptoms are absent.