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Introduction: Hodgkin’s lymphoma is a reticuloendothelial system malignancy that is almost completely confined to lymph nodes. Extranodal involvement is rare in Hodgkin’s lymphoma. Pulmonary involvement is also rare condition in this disease. In our case, we aimed to report radiological findings of a 28 year old male patient with Hodgkin’s lymphoma involving bilateral lungs.
Case Presentation: A 28-year-old man with abdominal pain, fever and cough was admitted to the emergency department of our hospital. The patient’s complaints of abdominal pain and cough have continued and have been increasing for the last month. After physical examination revealed sensitivity in the abdomen and fever, the patient was referred to radiology. In ultrasonographic examination, we found that the size and echogenity of kidneys were increased bilaterally and multiple hypoechoic lesions with minimal peripheral blood supply at doppler sonography with a largest diameter of 45 mm were observed in both kidneys. When the scanning area was expanded to clarify the patient clinic, a number of pathological lymph nodes up to 4 cm in size in both inguinal regions, paraaortic area and cervical region and several hypoechoic lesions in the spleen were observed. Because of the pathological lymph nodes, lesions in the spleen and no sign of inflammation at the perirenal regions led us to pre-diagnosis of lymphoma. On chest X-ray, there was a significant expansion at mediastinum and multiple irregular opacities in bilateral lung parenchyma. In addition, in the thoraco-abdominal CT examination, multiple conglomerated LAPs were found at bilateral hilar area in the mediastinum and there were diffuse focal irregularly consolidated areas in the lung parenchyma and sclerotic appearance in the L2 vertebra (ivory vertebra). Histopathological evaluation revealed nodular sclerosing Hodgkin’s lymphoma.
Conclusion: Hodgkin lymphoma constitutes 1% of all cancers and 25-40% of lymphomas. It shows bimodal age distribution in developed countries, peaks in the 20s and after 45 years of age. In all age groups, Hodgkin lymphoma is more common in men, but in the nodular sclerosing type it is more common in women contrary to our case. In the treatment of Hodgkin lymphoma, chemotheraphy and radiotheraphy is recommended alone or combined. Even it is very rare, radiologists should be aware of the widespread involvement of the Hodgkin’s lymphoma as in our case.