Frosted branch angiitis with undiagnosed Hodgkin lymphoma

To report the case of a patient with bilateral frosted branch angiitis and undiagnosed Hodgkin lymphoma.

Review of clinical history, laboratory findings, histology of supraclavicular lymph node biopsy, and follow-up.

A 22-year-old man presented with a sudden, bilateral visual loss. Fundus examination and fluorescein angiography disclosed a bilateral frosted branch angiitis that was dramatically responsive to systemic corticosteroid therapy. Laboratory tests were unremarkable but radiologic studies showed extensive mediastinal and supraclavicular lymphadenopathy. A supraclavicular lymph node biopsy led to the diagnosis of nodular sclerosis Hodgkin lymphoma.

The occurrence of frosted branch angiitis in combination with classical Hodgkin lymphoma, although possibly coincidental, raises the possibility of a paraneoplastic syndrome. Thus, we suggest that, for patients with frosted branch angiitis, Hodgkin lymphoma should be considered in the diagnostic workup.