Hodgkin lymphoma - nodular sclerosing variant

Case contributed by Bálint Botz
Diagnosis certain

Presentation

Chest pain worsened by breathing, elevated inflammatory markers and D-dimers. PE? Pneumonia? Tumor?

Patient Data

Age: 45 years
Gender: Male

CT scout image already demonstrates striking widening of the upper mediastinum. 

Diffuse, confluous 15-20 mm short diameter pathological lymph nodes throughout the mediastinum, particularly in the paratracheal and upper-anterior part, where a larger conglomerate can be observed. 

An about 60 x 40 mm axial diameter spiculated intrapulmonary mass in right segment 5, smaller nodules elsewhere. 

Findings are in line with a large right-sided pulmonary neoplasm and marked lymphadenomagely predominantly in the upper-anterior mediastinum, suggestive of pulmonary manifestations of lymphoma. 

Case Discussion

Subsequent VATS biopsy confirmed Hodgkin lmyphoma (nodular sclerosing variant). 

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