Primary pulmonary Hodgkin's disease.

Primary pulmonary Hodgkin's disease is a rare but distinct entity, to be distinguished from nodal Hodgkin's disease and from lymphomas involving the lung secondarily. Sixty-one cases have now been reported in the world's literature. This lymphoma affects women more frequently than men, and typically involves the superior portions of the lungs. Radiologically, it appears as a solitary mass or multinodular disease; inhomogeneity or cavitation of these lesions are common. Since the presentation of this disease is nonspecific, and as noninvasive tests are rarely revealing, diagnosis requires an open thoracotomy and lung biopsy. Factors which correlate with a poorer prognosis include "B" symptoms, bilateral disease, multilobe involvement, penetration of the pleura, and cavitation. The staging and treatment of these lymphomas according to the extent of pulmonary involvement are recommended, as radiotherapy or combination chemotherapy may be effective in appropriately selected patients.