Cholestatic Jaundice as the Initial Manifestation of Classical Hodgkin Lymphoma: A Diagnostic Challenge

Hodgkin lymphoma (HL) is a cancer of the lymphatic system that typically presents with systemic B symptoms and lymphadenopathy, while hepatic involvement is rare, and initial presentation with liver dysfunction is uncommon. We report a case of a 47-year-old patient who presented with progressive jaundice and generalized weakness. His clinical course and laboratory findings suggested multiple possible causes, and due to diagnostic uncertainty, a liver biopsy was performed, revealing Hodgkin and Reed-Sternberg cells consistent with classical HL. This case highlights a rare initial hepatic presentation of HL manifested as cholestatic jaundice and underscores the importance of considering infiltrative malignancies in the differential diagnosis of unexplained liver dysfunction, as well as the critical role of liver biopsy when noninvasive evaluations fail to provide a conclusive diagnosis.