Primary Pulmonary Hodgkin’s Disease

Epidemiology

  • Extremely rare (few isolated cases)
  • Most cases reported in older patients (F>M)

Physiology

  • Hodgkin’s arising from lymphoid follicles or peribronchial lymph nodes

Pathology

  • Pathognomonic Reed-Sternberg cell

Diagnosis

  • OLB: usually required for diagnosis in reported cases

FOB: TBB may be diagnostic

CXR/Chest CT Pattern (usually unilateral, rarely bilateral, with upper lobe predominance):
1) Solitary Lung Nodules: with absence of hilar/mediastinal nodes (necessary to diagnose primary disease in lung)
2) Diffuse Infiltrates: as in #1
3) Cavitation: as in #1


Clinical

  • Symptoms/Signs:
    -B symptoms (common): fever/night sweats/ weight loss

See also Lung nodules/<3 Symptoms: -B symptoms (common): fever/ night sweats/ weight loss Signs:


Treatment

  • Disease Isolated to Lungs: surgery + XRT
  • Disease with Lungs + Other Nodes: stage-dependent
  • Extranodal Disease: chemo (controversial

References

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