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March 21, 1980

An Unusual Manifestation of Non-Hodgkin's Lymphoma: Fibrosis Masquerading as Ormond's Disease

Author Affiliations

From the Departments of Medicine (Maj Dlabal) and Pathology (Col Mullins), Wilford Hall Medical Center, Lackland AFB, Tex; and the Division of Oncology, Department of Medicine, University of Texas Health Science Center at San Antonio (Dr Coltman).

JAMA. 1980;243(11):1161-1162. doi:10.1001/jama.1980.03300370035024

NODULAR poorly differentiated lymphocytic lymphoma (NLPD) and idiopathic retroperitoneal fibrosis (IRF), or Ormond's disease,1 are protean in their manifestations. Lymphoma occurs in virtually every organ, and IRF involves many areas outside the retroperitoneum, including the testis and brain. We describe a case that was erroneously reported as IRF involving the spinal cord2 but, on further analysis, has been shown to be a classic case of non-Hodgkin's lymphoma in which sclerosis is a prominent feature. Fibrosis, the factor that obscured the diagnosis, may have had important prognostic implications.

Report of a Case  A 67-year-old woman was informed that she had Brill-Symmer's disease (giant follicular lymphoma) based on findings from a cervical node biopsy done at another hospital in 1956. She was well with no therapy until 1967 when she came to Wilford Hall US Air Force Medical Center with flank pain and right hydronephrosis. At ureterolysis, performed in August