Presentation
Bilateral neck lumps progressing over six months. Increasing dyspnea 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.
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Bulky nodal disease in the right supraclavicular fossa. The mass appears to be separate from the thyroid tissue.
Multiple low-attenuation masses throughout superior mediastinum, surrounding and narrowing the trachea (minimum 9 x 7 mm) and vascular structures.
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.