Digital Clubbing and Hodgkin Disease in Children: A Case Report and Review of Literature

Introduction: Digital clubbing (hypertrophic osteoarthropathy) as the initial presentation of lymphoma is rarely reported, particularly in children. In this study, we report a patient with intrathoracic Hodgkin Disease (HD) and digital clubbing as the first presentation, and we will review the literature regarding the same condition. Case Presentation: A 10-year-old boy presented with a 2-month history of cough, mild dyspnea, and night sweats, with prominent digital clubbing. A chest x-ray and a computed tomography scan of the chest showed multiple mediastinal masses. A mediastinal lymph node biopsy was done. Pathologic examination was indicative of nodular sclerosis HD. Conclusions: In patients with digital clubbing, intrathoracic malignancies should be considered a differential diagnosis and must be ruled out by precise examination and paraclinical help.

MDCT Evaluation of Hepatic Manifestations in Malignant Hematological Disorders

Objective: The aim of this work was to evaluate Multidetector Computed Tomography (MDCT) findings of hepatic manifestation in common malignant hematological disorders. Materials and Methods: This retrospective study included 300 patients with different types of malignant hematological disorders. They were 119 female and 181 male (mean age, 45.4 year; range, 5-70 years). The most common hematological disorder was Non-Hodgkin lymphoma (NHL) detected in 192/300 (64%) patients and then Hodgkin disease (HD) detected in 40/300 (13.3%) patients. All 300 patients had ultrasonography. Clinical evaluation and laboratory assessment were done for all patients. Whole body and triphasic abdominal CT scanning was performed on 64 MDCT systems. Results: MDCT scanning revealed hepatic affection in 82/192 of NHL. All these 82 cases revealed hepatomegaly and focal lesion detected in 36 cases. As regard Hodgkin disease (HD), hepatomegaly detected in 22/40 cases and focal lesion detected in 8/40 cases. Hepatomegaly detected in 8/14 cases of acute myeloid leukemia (AML) and focal lesion detected in 4/14 cases. In cases of chronic lymphocytic leukemia (CLL), hepatomegaly detected in 6/22 cases with no detection of focal lesion. Conclusion: Hepatic involvement is often observed in several malignant hematological disorders, resulting in abnormalities in liver imaging studies. Malignant hematological disorders must be considered in hepatomegaly and hepatic focal lesions either single or multiple. MDCT is the diagnostic modality of choice for diagnosis and follow up of liver affection in different malignant hematological disorders.