Hodgkin's Disease in Bone, with Special Reference to Periosteal Reaction

One hundred and eight patients with Hodgkin's disease showing bone lesions have been studied to determine the frequency, sites and type of involvement. One hundred of these had at least a five-year follow up. Bone lesions are generally evidence of widespread dissemination of the disease and are therefore of serious prognostic import; at least 60 per cent of patients dying within two years of the appearance of their first bone lesion, and almost 80 per cent within three years. The five-year survival of patients after the development of a bone lesion is only 4·25 per cent in contrast to the general five-year survival in this series of 41 per cent. No particular type of bone lesion affected the prognosis. The incidence of periosteal reaction in this series was very high (29·5 per cent) and we regard this as a valuable diagnostic sign of Hodgkin's disease, especially when it occurs on the lateral border of a vertebra.