[Thoracic involvement in Hodgkin's lymphoma]

Hodgkin's lymphoma is defined by a malignant prolifération of Reed-Sternberg or Hodgkin cells that are clonally related B-cell-derived malignant cells. This disease is characterized by a good outcome (cure rate more than 80%). Initial thoracic involvement is usual and the more frequent localization is the mediastinum, following by the lung parenchyma and the pleura. In the last two cases, histological diagnosis is warranted since this involvement modified the staging and the prognosis of the disease.

Early one, infectious diseases were the most frequent complications. Functional deficiency following mediastinal radiotherapy and chemotherapy (including bleomycin) is often detected, whatever this is associated with symptom or CT scan abnormalities. Granulomatous disease can be associated at any time during the disease and differential diagnosis from relapse is often difficult. Finally, these patients have an increased risk of developing solid cancers and particularly lung cancers.

Hodgkin lymphoma patients are more likely to die from acute and late treatment-related toxicities and the major task is to reduce treatment associated toxicity while maintaining cure rate.