An Atypical Presentation of Hodgkin Lymphoma Invading the Myocardium

Pericardial involvement by Hodgkin lymphoma has been found in up to 20% of children at presentation, but disease of the myocardium itself is rare. We describe an 18-year-old male with HL who presented with a large mediastinal mass, pericardial effusion, and tumor invasion of both atrial walls with intra-atrial extension. A PubMed search of publications between 1989 and 2022 was conducted and additional older references were identified among these publications. While pericardial disease is described in numerous case series, myocardial involvement by HL, diagnosed clinically rather than at autopsy, is distinctly unusual.