Hodgkin lymphoma
Presentation
Bilateral neck lumps. Progressing over six months. Increasing dyspnoea when lying flat or swallowing.
Patient Data
Bilateral abnormal cervical lymph nodes in neck and supraclavicular fossae.
US guided core biopsy taken from right sided mass.
Staging CT
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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 9x7mm) and vascular structures.
Bulky nodal disease in the left supraclavicular fossa. The mass appears to be separate from the thyroid tissue.
Normal intracranial appearances. Visualised lung normal. No associated abnormalities in the abdominal or bone sequences.
Case Discussion
With this acute presentation, in discussion with haematology, high dose steroids were started and a formal nodal biopsy was taken.
The pathology confirmed classical Hodgkin's lymphoma. PET staged the cancer as IIB and the patient commenced chemotherapy.
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