Lee Soo Jeong, Rho Ji Young, Kim Gwang Il, Park Joonsuk
Department of Radiology Department of Pathology Department of Thoracic Surgery, CHA Bundang Medical Center, CHA University, Bundang-gu, Seongnam-si, Republic of Korea.
Medicine (Baltimore). 2018 May;97(19):e0607. doi: 10.1097/MD.0000000000010607.
In the thorax, Hodgkin lymphoma (HL) most frequently involves the anterior mediastinal and paratracheal regions and tends to spread to contiguous nodal groups. Enlarged lymph nodes typically have homogeneous soft tissue attenuation similar to that of muscle tissue on computed tomography (CT).
A contrast-enhanced CT examination of a 19-year-old man with right-sided chest pain showed an intense, heterogeneously enhancing mass with organization of serpentine and dilated blood vessels in the right anterior mediastinum that had invaded the upper lobe of the right lung.
Following a wedge resection, histopathological examination showed Reed-Sternberg cells that were positive for CD-15 and CD-30, which is typical of HL.
The patient was started treatment with 6 cycles of doxorubicin, bleomycin, vincristine, and dacarbazine (ABVD) regimen.
After chemotherapy, the patient had shown a partial response to the treatment.
This presentation of HL as an extremely hypervascular anterior mediastinal mass on CT imaging has not been previously reported in the literature. This case suggests that HL should be included in the differential diagnosis of a hypervascular anterior mediastinal mass, especially if the patient is a young adult.
在胸部，霍奇金淋巴瘤（HL）最常累及前纵隔和气管旁区域，并倾向于扩散至相邻的淋巴结组。肿大的淋巴结在计算机断层扫描（CT）上通常具有与肌肉组织相似的均匀软组织密度。
一名19岁右侧胸痛男性的增强CT检查显示，右前纵隔有一强化明显、强化不均匀的肿块，伴有蜿蜒迂曲和扩张的血管，并侵犯了右肺上叶。
楔形切除术后，组织病理学检查显示里德-斯腾伯格细胞CD-15和CD-30呈阳性，这是HL的典型表现。
患者开始接受6个周期的多柔比星、博来霉素、长春新碱和达卡巴嗪（ABVD）方案治疗。
化疗后，患者显示出部分治疗反应。
CT成像显示HL表现为前纵隔极高血运肿块，此前文献未见报道。该病例提示，HL应纳入前纵隔高血运肿块的鉴别诊断，特别是患者为年轻成年人时。
