Hodgkin lymphoma presenting as multiple cavitary pulmonary nodules with associated mediastinal adenopathy and neck mass.
Hodgkin lymphoma involving the lung may present in a variety of radiographic and clinical patterns including solid or necrotizing lesions, with or without associated mediastinal adenopathy. Cavitary pulmonary lesions are exceedingly rare, occurring in less than 1% of cases, and are typically solitary. We report a case of an 18-year-old male presenting with multiple cavitating pulmonary nodules and a palpable mass in the neck. Imaging revealed associated mediastinal and cervical adenopathy. Biopsy of the neck mass and lung nodule initially revealed necrosis and granulomata, suggesting infection. Treatment for a presumed infectious etiology was without resolution. Subsequent open lung biopsy revealed marked granulomatous inflammation with diagnostic Reed-Sternberg cells. Hodgkin lymphoma should always be considered in the differential diagnosis of cavitary pulmonary lesions, especially those refractory to treatment.
Bieliauskas
Shannon
S
Department of Anatomic Pathology, William Beaumont Hospital, Royal Oak, MI 48073-6769, USA.
Reyes-Trocchia
Alma
A
Krasan
Graham P
GP
Main
Charles
C
Trupiano
Jacqueline K
JK
D000293:Adolescent; D001706:Biopsy; D003937:Diagnosis, Differential; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000473:pathology; D006689:Hodgkin Disease / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis / Q000473:pathology; D055613:Multiple Pulmonary Nodules / Q000175:diagnosis / Q000473:pathology; D016539:Reed-Sternberg Cells