An 81-year-old male presented to the emergency room with a 3-month history of progressive shortness of breath, productive cough with white sputum, and generalized weakness with 10-pound weight loss in 2 months, according to a case report published in the Journal of Investigative Medicine High Impact Case Reports.
On presentation, the patient was afebrile, with a blood pressure of 93/55 mm Hg and an oxy-hemoglobin saturation of 92% on 2 liters of oxygen via nasal cannula, as detailed in the 2017 study. A complete blood count with differential showed a white count of 12 400/mL, and the brain natriuretic peptide level was 454 ng/mL.
A postero-anterior chest radiograph revealed multiple round opacities in the lung fields. A computed tomography scan of the chest confirmed multiple round densities in both lung fields alongside mild mediastinal lymphadenopathy, according to the case report. Following these findings, a core needle biopsy was performed.
Immunohistochemical stains returned positive for CD30 and CD15 within a population of large atypical cells situated within a background of CD3-positive nonneoplastic cells, as reported in the journal publication. These histological results supported a diagnosis of classical Hodgkin’s lymphoma of the lung, specifically confirming the nodular sclerosis type.
Primary pulmonary Hodgkin’s lymphoma of the lung is a rare entity. The authors said it should be considered as a differential diagnosis when evaluating lung masses, and they said a definite diagnosis requires biopsy and histology. Early start of chemotherapy and regular follow-up with oncology are essential when managing such cases.
The patient was initially started on chemotherapy, but was readmitted 20 days later for acute respiratory distress, suffered a cardiac arrest, and subsequently died, according to the clinical report.
