Hodgkin's Lymphoma Presenting as a Cavitary Lung Lesion

Hodgkin lymphoma (HL) typically presents in the nodal regions at an early stage of the disease. Occasionally, patients can present with disease in extranodal regions. We report a case of HL in a 25-year-old female who presented to the emergency department following a motor vehicle accident with incidental findings of pulmonary cavitary lesions, fever, tachycardia, anemia, leukocytosis and thrombocytosis. This case illustrates the difficulty in diagnosis when the disease presents in extranodal regions with nonspecific systemic symptoms. Complete workup for infectious and autoimmune etiology was performed and found to be negative. CT guided biopsy and bronchoscopy failed to yield the diagnosis; a video-assisted thoracoscopic surgery was necessary to obtain the diagnosis of advanced-stage HL in this patient.