Hodgkin Lymphoma As the Underlying Cause of a Chronic Cough

Hodgkin lymphoma (HL) is a monoclonal lymphoid neoplasm derived from B cells and is one of the most common lymphomas among young adults in developed countries. It typically presents insidiously, often as a painless cervical lymphadenopathy or an asymptomatic mediastinal mass. B symptoms (fever, night sweats, and weight loss), fatigue, pruritus, or alcohol-induced pain may be present along with respiratory symptoms in cases of mediastinal involvement. A definitive diagnosis requires lymph node biopsy for histological and immunophenotypic evaluation. We report the case of a 24-year-old female smoker with a childhood history of asthma, who presented with a three-month history of dry cough, fever, night sweats, anorexia, and significant weight loss. Subsequently, she developed pelvic girdle pain, pleuritic chest pain, and dyspnea while lying down. A computed tomography (CT) of the chest showed mediastinal lymphadenopathy and consolidation in the right middle lobe with cavitations. Following referral to hematology, a CT-guided mediastinal biopsy confirmed the diagnosis of HL, and a positron emission tomography revealed advanced disease stage IV.