Samir IDDIR, Brahim LOUNIS, Zakia Batoul BENLAHRECHE, Arezki SAIDANI
Türkiye Çocuk Hastalıkları Dergisi - 2026;20(4):298-301
Hodgkin lymphoma (HL) in pediatric patients typically presents with mediastinal and supradiaphragmatic lymphadenopathy. Predominant skeletal involvement at diagnosis is exceptionally rare and represents a significant diagnostic challenge. We present the case of a 10-year-old child with a 6-month history of progressive weight loss, right hip pain, and gait disturbance. Initial imaging suggested non-malignant orthopedic conditions, but further studies revealed multifocal osteolytic bone lesions. A bone biopsy ultimately confirmed classical Hodgkin lymphoma. A Positron Emission Tomography/Computed Tomography (PET/CT) scan demonstrated intensely hypermetabolic osseous lesions with only minimal, disproportionately mild, nodal disease. Based on the Lugano classification, the patient was classified as Ann Arbor stage IV. The patient exhibited rapid clinical improvement following the initiation of OEPA (Vincristine, Doxorubicin, Etoposide, Prednisone) induction chemotherapy. This case underscores the importance of including lymphoproliferative disorders in the differential diagnosis of unexplained multifocal osteolytic lesions in children and highlights the critical role of timely tissue biopsy.
