Pulmonary parenchymal involvement by Classic Hodgkin Lymphoma – An unusual presentation

Abstract

Pulmonary involvement of Hodgkin’s disease is often encountered. However, presentation in the form of “pneumonia-like” consolidation is rare. A case is being described where a 31-year-old male patient presented with respiratory distress, intermittent fever, cough, and cervical lymphadenopathy for the past 2–3 months. Contrast-enhanced computed tomographic scan of thorax revealed a consolidation at anterior segment of the right upper lobe with atelectasis and mediastinal lymphadenopathy. CT-guided biopsy from the right lung lesion revealed infiltration by inflammatory cells mainly lymphocytes and eosinophils with presence of a few scattered atypical mononuclear and occasional binucleated cells. These atypical cells were immunopositive for CD 15 and CD 30 and negative for CD 45, CD 20, Epstein Barr Virus Latent Membrane Protein (EBV LMP 1), and multiple myeloma 1 (MUM 1). The final diagnosis was pulmonary involvement by Classic Hodgkin’s lymphoma. The present case is being depicted for its unusual clinical and radiological presentation.