UNUSUAL BONE-MARROW RELAPSE OF HODGKINS-DISEASE WITH TYPICAL PEL-EBSTEIN FEVER

We report the unusual case of a 43-year-old man with a diagnosis of cl inical stage I A mixed cellularity Hodgkin's disease (HD), who relapse d 4 years after diagnosis with exclusive bone marrow involvement and a cyclic variation in body temperature typical of Pel-Ebstein fever. In the absence of clinical and laboratory signs of infection, a restagin g of the lymphoma was performed. Total-body CT scan revealed no parenc hymal or lymph node involvement, while a bone-marrow biopsy was positi ve for the presence of Reed-Sternberg cells. Therefore, the patient wa s started on combination chemotherapy, which promptly induced a normal ization of the temperature curve. The presence of typical Pel-Ebstein fever, which is reported to be very rare, in association with bone mar row localization as the only site of relapse, suggests a relationship between these two rare manifestations of the disease.