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Hodgkin lymphoma

Case contributed by James Sheldon
Diagnosis almost certain

Presentation

Left neck swelling. Fatigue and fever.

Patient Data

Age: 25 years
Gender: Male
ct

Extensive lymphadenopathy is demonstrated within the left side of the neck, particularly the posterior triangle, where the largest node measures 21mm x 23mm in axial dimensions. No lymph node enlargement is seen in the right side of the neck.

Marked lymph node enlargement in the thorax with a cluster of nodes measuring 50mm x 25mm in the para-aortic region. A 32mm x 25mm subcarinal lymph node is also prominent.

No focal consolidation, pulmonary nodule or mass is identified. Moderate sized left sided pleural effusion with associated atelectasis.

The findings are consistent with biopsy proven Hodgkin lymphoma.

Case Discussion

Hodgkin disease is a type of lymphoma and accounts for approximately 1% of all cancers. HD spreads contiguously and predictably along lymphatic pathways and is curable in 85 to 95% of cases, depending on its stage and sub-type.

The disease is characterized by the presence of Reed-Sternberg cells (considered to be a type of B cell).

Hodgkin's disease is usually almost entirely confined to the lymph nodes.

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