A case of sternal involvement in an early relapse of hodgkin disease verified with ultrasound guided core needle biopsy

Sternal involvement in Hodgkin lymphoma rarely occurs at the initial stages of the disease but is one of the possible locations that should be considered. Although several imaging diagnostic modalities exist, none of them provides histological information. In this case report we present a 33-year-old man with an early relapse of the disease involving the sternum suspected from the data obtained by contrast enhanced CT and scintigraphy. An ultrasound image guided core needle biopsy was used to provide us with histological confirmation of sternal infiltration by the primary disease. Although CT, MRI, PET and scintigraphy are preferred for the diagnosis, follow-up and biopsy guidance of tumor lesions involving or adjacent to the chest wall or sternum, ultrasound examination can provide additional information and may assist in the obtainment of an adequate biopsy specimen especially in the cases with a superficial malignant bony lesion with an anterior cortical break.