Case 6

Female 40 y.o. Complaints of weakness, dizziness, ecchymoses of lower extremities. 06.07.15 — tick bite. From 12.08.15 signs of renal bleeding, marked ecchymoses of lower extremities. Bruising, bleeding and the decrease in hemoglobin noted since 6 случайchildhood. In September takes high dose prednisolone for acquired hemorrhagic diathesis. At scintigraphy of the skull, thorax, shoulder girdle, spine and pelvis no preparation hyperfixation centers are seen except some minor accumulation of the radioisotope in the bones of the cranial vault. At CT in December 2015, a structurally homogeneous pathologic mutifocal lesion with blurry distinguishable contours affecting the whole left humerus (except for a small epiphyseal portion) is determined. The material was submitted to our laboratory for second opinion. The primary diagnosis of Hodgkin lymphoma on the background of the use of prednisolone. The material was sent for second opinion before starting the treatment of Hodgkin’s lymphoma.