Hodgkin lymphoma

Case contributed by Dr Derek Smith

Presentation

Bilateral neck lumps. Progressing over six months. Increasing dyspnoea when lying flat or swallowing.

Patient Data

Age: 25
Gender: Female
Ultrasound

Bilateral abnormal cervical lymph nodes in neck and supraclavicular fossae.

US guided core biopsy taken from right sided mass.

CT

Staging CT neck/chest

Extensive nodal disease in the right neck from level III extending into the right supraclavicular fossa.

Multiple low-attenuation masses throughout superior mediastinum, surrounding and narrowing the trachea (minimum 9 x 7 mm) and vascular structures.

Bulky nodal disease in the left supraclavicular fossa. The mass appears to be separate from the thyroid tissue.

Normal intracranial appearances. Visualized lung normal. No associated abnormalities in the abdominal or bone sequences.

Case Discussion

With this acute presentation, in discussion with hematology, high dose steroids were started and a formal nodal biopsy was taken.

The pathology confirmed classical Hodgkin lymphoma. PET staged the cancer as IIB and the patient commenced chemotherapy.

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Case information

rID: 36859
Published: 18th Aug 2015
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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