Hodgkin's disease in a child with acute lymphoblastic leukemia

Hodgkin's disease as a second malignancy in childhood acute lymphoblastic leukemia is of rare occurrence, with the first such case having only recently been described. The therapy for acute lymphoblastic leukemia may alter the pattern of presentation of Hodgkin's disease and its histology, making diagnosis difficult. In this report we discuss the clinical, histologic, and ultrastructural findings of a child with acute lymphoblastic leukemia in remission who had pulmonary involvement as an unusual initial presentation of Hodgkin's disease.