Extranodal Epstein-Barr virus-negative Hodgkin lymphoma of the oropharynx

Classical Hodgkin lymphoma (cHL) arising from extranodal regions of the head and neck is uncommon, with the lymphocyte-rich (LR) subtype referenced only once in the literature. This report herein illustrates a man in his 40s with a 6-month history of a painless lump in his throat, with Magnetic Resonance Imaging (MRI) revealing a 3-cm mass in the left posterolateral oropharynx. Histopathologic examination after transoral pharyngectomy revealed LR cHL. In situ hybridisation (EBER1) indicated negative Epstein-Barr virus (EBV) testing. 27 months after excision, the LR cHL recurred in the left nasopharynx. After another resection, he underwent definitive chemotherapy treatment with no evidence of disease 14 months later. This represents the first documented case of EBV-negative, LR cHL arising from the oropharynx, with locoregional recurrence in the left nasopharynx. This report demonstrates that the prompt identification of rare malignancies can significantly alter treatment protocols and patient outcomes.