Hodgkin’s lymphoma

Hodgkin's lymphoma is a form of cancer, originating from white blood cells, called lymphocytes. It is the most common lymphoma.

The disease is characterised by the orderly spread of disease from one lymph node group to another and by the development of systemic symptoms with advanced disease. Later stages affect the imune system. When Hodgkin cells are examinated under the microscope, multinucleated Sternberg-Reed cells can be easily found.

The disease occurrence shows two peaks: the first in young adulthood (age 15–35) and the second in those over 55 years old.

Symptoms may include: swelling of the axilar, cervical and inguinal lymph nodes, high fever, weight loss, fatigue, night sweats.

Treatment usually consists of chemo and radio therapy.

This case presents a 26 year old pacient, diagnosed with a mediastinum tumor of unkonwn etiology, altered general status, dyspnea, sternal pain, loss of appetite.

Preoperative CT result shows a well defined tumoral growth with heterogeneous tissue density, size 32/76/60mm, located in the superior and middle anterior mediastinum, with a possible invasion of the right plaeura. Few mediastinal lymph nodes, smaller than 1 cm are also present.

Postoperative ct result shows the disappearance of the tumoral growth with the reduction in size of the mediastinum lymph nodes.

Bronchoscopy exam shows a normal aspect. No localised processes, external compressions or macroscopic alterations.

Spirometry results: VC 104%, PEF 108%

Given the fact that there are no swollen peripheral lymph nodes, the treatment consists of pericardial puncture, revealing clear liquid and mediasninum puncture with a negative result.

The surgical procedure consists of medial sternotomia followed by total excision of the tumor, partial bilateral pulmonary resection and partial plaeurotomia.

Histopathological exam reveals malignant Hodgkin` lymphoma.

This case was later transfered to the oncology clinic for speciality treatment.