Sawaftah Zaid, Awashra Ameer, Bani Odah Ali, Sawafta Ahmed, Alawna Abed, Khamaysa Jehad, Abdalqader Mohammed, Ghannam Yazan
Department of Medicine, An-Najah National University, Nablus, PSE.
Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, PSE.
Cureus. 2024 Jul 28;16(7):e65569. doi: 10.7759/cureus.65569. eCollection 2024 Jul.
Hodgkin lymphoma (HL), a lymphoid neoplasm characterized by the presence of Reed-Sternberg cells, often presents with painless lymphadenopathy and systemic symptoms. This case report details the diagnostic journey of a 27-year-old non-smoker female with chronic respiratory symptoms, including persistent cough, hemoptysis, and weight loss over two years. Despite multiple treatments for presumed infections and extensive diagnostic procedures, the correct diagnosis of HL was delayed due to atypical pulmonary manifestations, notably necrotizing pneumonia and multiple cavitary lung lesions. Ultimately, histopathology from a third bronchoscopy confirmed HL, highlighting the complexity of diagnosing HL with unusual presentations. Patients with cavitary lesions have a poor prognosis compared to others with typical pulmonary involvement, as cavitation in HL is likely caused by central ischemia necrosis due to the tumor's rapid growth. This case can be considered a primary pulmonary HL, a rare and hard-to-treat presentation since it does not respond well to radiotherapy. It emphasizes the challenge in diagnosing HL when it presents atypically, making it crucial to consider HL in differential diagnoses to avoid delayed diagnosis and improve patient outcomes.
霍奇金淋巴瘤（HL）是一种以里德-斯腾伯格细胞为特征的淋巴样肿瘤，常表现为无痛性淋巴结病和全身症状。本病例报告详细介绍了一名27岁不吸烟女性的诊断过程，该患者有慢性呼吸道症状，包括持续咳嗽、咯血和两年多来的体重减轻。尽管对疑似感染进行了多次治疗并进行了广泛的诊断程序，但由于非典型肺部表现，特别是坏死性肺炎和多个肺空洞病变，HL的正确诊断被延迟。最终，第三次支气管镜检查的组织病理学确诊为HL，突出了诊断表现不寻常的HL的复杂性。与其他典型肺部受累的患者相比，有空洞病变的患者预后较差，因为HL中的空洞可能是由于肿瘤快速生长导致的中央缺血坏死所致。该病例可被视为原发性肺HL，这是一种罕见且难以治疗的表现，因为它对放疗反应不佳。它强调了非典型表现的HL诊断中的挑战，使得在鉴别诊断中考虑HL以避免延迟诊断并改善患者预后至关重要。
