title: Rhabdomyosarcoma masquerading as lymphadenopathy in a patient with newly diagnosed Hodgkin's lymphoma.
abstract: BACKGROUND
  Hodgkin's lymphoma (HL) is a rare malignancy which often presents with lymphadenopathy and classic "B symptoms" of weight loss, fever, and night sweats. Additional masses or nodes could easily be presumed to be a result of the initial diagnosis. On the other hand, adult rhabdomyosarcoma is a rare malignancy presenting with a new mass in a patient with previous diagnosis of Hodgkin's lymphoma. In both cases, a tissue diagnosis should be obtained to appropriately confirm the diagnosis.
  
  
  METHODS
  We present a case of a 64-year-old male who presents with right axillary lymphadenopathy, diagnosed as Hodgkin's lymphoma. He subsequently developed left inguinal lymphadenopathy without the classic B symptoms of HL. Excisional biopsy revealed rhabdomyosarcoma. Stage III Hodgkin's lymphoma (lymph node involvement on both sides of the diaphragm) is not commonly seen without typical B symptoms. Once the diagnosis of two primary malignancies is made, the dilemma becomes determining the treatment course. In the case of Hodgkin's lymphoma and rhabdomyosarcoma, there is some overlap in the chemotherapeutic regimen and use of radiation.
  
  
  CONCLUSIONS
  This case illustrates the importance of careful examination of Hodgkin's lymphoma patients and consideration of additional tissue diagnoses in atypical presentations of new masses or lymphadenopathy on the opposite side of the diaphragm.
authors.affiliation: Department of Surgery, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Brooklyn, NY, 11201, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Dergan
authors.affiliation: Department of Surgery, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Brooklyn, NY, 11201, USA.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Sirsi
authors.affiliation: Department of Surgery, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Brooklyn, NY, 11201, USA.
authors.forename: Armand
authors.initials: A
authors.lastname: Asarian
authors.affiliation: Department of Hematology/Oncology, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Brooklyn, NY, 11201, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Guevara
authors.affiliation: Department of Pathology and Laboratory Medicine, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Brooklyn, NY, 11201, USA. pxiao@tbh.org.
authors.forename: Philip
authors.initials: P
authors.lastname: Xiao
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D006689:Hodgkin Disease / Q000175:diagnosis*; D006801:Humans; D000072281:Lymphadenopathy / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012208:Rhabdomyosarcoma / Q000175:diagnosis*
keywords: Alveolar type; Hodgkin’s lymphoma; Lymphadenopathic rhabdomyosarcoma; Nodular sclerosing type