Unusual bilateral lymphadenopathy revealing Hodgkin's lymphoma: a case report

Hodgkin lymphoma is a rare lymph node malignancy that has the presence of Reed-Sternberg cells. We describe a case of a 72-year-old male with progressive bilateral cervical and inguinal lymphadenopathy with the absence of constitutional symptoms. Primary clinical and radiographic assessment was in favor of an infectious or metastatic etiology. Classical Hodgkin lymphoma was confirmed by excisional biopsy of the lymph nodes that demonstrated classic Reed-Sternberg cells in a polymorphous inflammatory background. Additional support to the diagnosis was provided by immunohistochemistry. The patient was staged at Ann Arbor stage IIIB disease and sent to oncologic care, where he was placed on systemic chemotherapy. The case demonstrates that persistent lymphadenopathy can be a hard-to-detect disease, particularly in tuberculosis-endemic regions, and that a timely biopsy and comprehensive evaluation are necessary to avoid diagnostic lag time and offer treatment before it is too late.