Secondary pulmonary lymphoma

Case contributed by Khalid Alhusseiny
Diagnosis almost certain

Presentation

Past history of Hodgkin lymphoma presented with swelling on the left side of the neck.

Patient Data

Age: 15 years
Gender: Female

Chest

ct

A comparison was made with an earlier study (not included in this case).

There is anterior mediastinal soft tissue lesion which showed time interval progression in its size as compared to the earlier study. The lesion is encasing and markedly attenuating the left innominate vein.

The lesion showed a new extension to the superior mediastinum and root of the neck explaining the new patient presentation with neck swelling. It is extending superiorly deep to the sternal end of the left sternocleidomastoid muscle and anterior to the left thyroid lobe.

Newly developed bilateral hilar and mediastinal enlarged lymph nodes are seen.

Right upper lung lobe apical and anterior opacities are also newly developed likely representing pulmonary lymphoma.

Case Discussion

This is a known case of Hodgkin lymphoma. The lung is a relatively common location in the secondary involvement of lymphoma. Secondary lung involvement is seen more in cases of Hodgkin lymphoma. The involvement can have variable appearances; among which pulmonary mass or nodule is the commonest as shown in this case.

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