GLUTEAL MANIFESTATION OF ADVANCED HODGKINS-DISEASE

Hodgkin's disease (HD) is a nodal malignancy with a characteristically axial pattern of spread and with contiguous progression via lymphatic channels. Even when dissemination occurs beyond the lymphoreticular s ystem, certain patterns of associated spread are frequently evident. W e describe a case of nodular sclerosis HD with a 12-year indolent cour se and late involvement of the gluteal muscle. Initially, stage was IV b with spleen and bone marrow involvement, complicated by a Coomb's po sitive hemolytic anemia. Following chemotherapy, the patient had a par tial response with the subsequent long course of slowly progressive di sease invading first the urinary bladder and, later, the gluteus. Invo lvement of the gluteal muscle is a rare event in HD. Spread to the glu teus occurred most likely by contiguity, via retroperitoneal lymphnode s.