Multiloculated Cavitary Primary Pulmonary Hodgkin Lymphoma: Case Series

Aljehani, Yasser; Alsaif, Hind S.; Al-Osail, Aisha M.; AL-Osail, Emad M.

doi:10.1159/000486824

Cited by 9 publications

(8 citation statements)

References 13 publications

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“…According to a study of 40 primary lung lymphoma, 1.5-2.4% were primary lung HL [15], while primary lung cHL was still not frequently seen even if in primary lung lymphoma. Previously reported primary lung HL typically involved the superior portions of unilateral lung [4,[16][17][18][19], while bilateral infiltrates of lymphoma were also seen [20]. In our study, 3 primary lung cHL patients had bilateral lung involvement and were identified to be multiple primary and in stage IV.…”

Section: Discussionsupporting

confidence: 52%

Clinical characteristics and prognostic factors of primary extranodal classical Hodgkin lymphoma: a retrospective study

et al. 2019

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Objectives: To analyze the clinical characteristics and prognosis of primary extranodal classical Hodgkin lymphoma (PE-cHL). Methods: Clinical features and outcomes of 22 PE-cHL patients who received initial chemotherapy January 2008 to January 2018 were analyzed retrospectively, and compared with 274 primary nodal Hodgkin lymphoma (PN-cHL) patients treated in the same period. Results: With a median follow-up period of 42 months, compared with 274 PN-cHL patients, no significant difference of overall response rate (ORR) or complete remission (CR) rate was found, but the PE-cHL patients showed a higher recurrence rate (36.4% vs. 13.1%, p = .003) and poorer survival [(5-year overall survival (OS) rate: 64.6% vs. 97.7%, p = .001; 5-year progression-free survival (PFS) rate: 42.4% vs. 82.2%, p < .001)]. To minimize the effects of confounding factors, PE-cHL patients were matched with PN-cHL patients at a ratio of 1:1 according to age, gender, histological types and stage. Compared with 22 matched PN-cHL cases, PE-cHL was still associated with poor PFS (5-year PFS: 42.4% vs. 79.9%, p = .004). As to 22 PE-cHL patients, univariate analysis showed elevated serum lactate dehydrogenase (LDH) and elevated platelet (PLT) were associated with poor PFS (p < .05). Discussion: Compared with PN-cHLs, PE-cHLs showed a considerable shorter duration of remission, higher recurrence tendency and poorer survival, indicating that more intensive therapy may be needed. Conclusion:The prognosis of PE-cHL is unfavorable. Elevated LDH and PLT are poor prognostic factors for PE-cHL.

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Section: Discussionsupporting

confidence: 52%

Clinical characteristics and prognostic factors of primary extranodal classical Hodgkin lymphoma: a retrospective study

et al. 2019

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“…Among the reported cases of HL with pulmonary involvement, the typical manifestation involves singular or multiple nodules or masses and primarily involves the superior portion of the lung [2,7] . Cavitary lung lesions, particularly multiloculated, are often associated with alternative etiologies such as mycobacterium tuberculosis (TB), aspergillosis, granulomatosis with polyangiitis, sarcoidosis, and rheumatic nodules [8] .…”

Section: Discussionmentioning

confidence: 99%

Hodgkin’s Lymphoma Presenting as Multiple Cavitary Lung Lesions

Jain

Al-Tarbsheh

Oweis

et al. 2021

European Journal of Case Reports in Internal Medicine

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Hodgkin Lymphoma (HL) typically presents similarly to an infectious etiology, thus awareness of its atypical presentations is essential. We present a case of an adult woman who was found to have HL after presenting with a dry, non-productive cough and showing cavitary lesions on chest computed tomography (CT). We also describe the clinical, laboratory, and radiological workup done leading to the diagnosis and management of HL in a critical care setting.

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“…A patient affected by pulmonary neoplasm is often debilitated with impaired cardiorespiratory function and frequently it is not possible to get tissue samples to achieve a comprehensive diagnosis. Primary pulmonary lymphoma comprises 0.5%‐1% of all primary pulmonary neoplasms and PPHL is a very rarely documented presentation of Hodgkin lymphoma consisting of <1% of all lymphomas and even less among primary pulmonary malignancies . FNA usually allows diagnostic material to be obtained from thoracic masses, which usually prevents the single major rare complication of pneumothorax .…”

Section: Discussionmentioning

confidence: 99%

Primary pulmonary Hodgkin lymphoma presenting as multiple cystic lung lesions: diagnostic usefulness of cell block

et al. 2020

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Classic primary pulmonary Hodgkin lymphoma (PPHL) is a rare event usually presenting as single or multiple nodules and more rarely as multiple cystic lesions. A patient affected by PPHL is often debilitated with impaired cardiorespiratory function and not suitable for invasive procedure to acquire a biopsy sample for histological diagnosis. Transthoracic ultrasound-guided fine needle aspiration (TUS-FNA) is a non-invasive procedure which gives the possibility to obtain a cytological sample that can be used to perform cell-block (CB). CB preparation can provide a diagnostic sample useful for additional analysis, such as immunocytochemical studies and molecular profiling. | C A S E HIS TORYA 18-year-old woman, without previous oncological history, presented to our Institution with fever, weight loss, dyspnoea and asthenia. At clinical evaluation, decreased air entry and fine crepitations at right upper pulmonary zone were present. Blood count was within normal limits. Erythrocyte sedimentation rate (120 mm/h) and C-reactive protein (20 mg/dL) were elevated. Blood cultures, expectorate and bronchioalveolar lavage did not identify infectious agents. Enhanced chest computed tomography scan (Figure 1C) showed large, partially cavitated lesions, 8 cm in maximum diameter, involving the right lung, predominantly the upper lobe. No mediastinal lymph node enlargement was detected. The clinical condition improved on steroid treatment. | MATERIAL S AND ME THODSTUS-FNA of one of the cystic lesions was performed. Specifically, ultrasound convex transducers with a central hole for needle passage ( Figure 1A) allows TUS-FNA using a dedicated convex probe: this method allows real-time visualisation of the needle ( Figure 1B) and acquisition cytological samples for CB preparation (Figure 1D).A 4-mL sample of pinky, non-corpuscolated fluid sample ( Figure 1D) was obtained and processed as CB preparation. Calcium chloride and plasma solution at 1:1 was added to fluid sample obtained from TUS-FNA until a clot was formed and subsequently admixed with 10% buffered formalin. Finally, the solid clot was automatically processed and embedded in paraffin. CB sections were prepared and stained with haematoxylin and eosin.

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Multiloculated Cavitary Primary Pulmonary Hodgkin Lymphoma: Case Series

Cited by 9 publications

References 13 publications

Clinical characteristics and prognostic factors of primary extranodal classical Hodgkin lymphoma: a retrospective study

Clinical characteristics and prognostic factors of primary extranodal classical Hodgkin lymphoma: a retrospective study

Hodgkin’s Lymphoma Presenting as Multiple Cavitary Lung Lesions

Primary pulmonary Hodgkin lymphoma presenting as multiple cystic lung lesions: diagnostic usefulness of cell block

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