Sputum cytologic diagnosis of Hodgkin's disease involving the lung

The development of pulmonary lesions during the course of Hodgkin's disease (HD) represents a diagnostic problem. Invasive studies are usually necessary to differentiate pulmonary parenchymal involvement with HD from infectious complications. A retrospective review has revealed five cases in which sputum cytodiagnosis of HD involving the lung was made. All cases were confirmed by either histopathologic examination or response to therapy. The cytology reveals a polymorphic picture with a large number of lymphoid mononuclear cells, macrophages, and unclassified cells. These cells usually have single nuclei that are lobulated and contain prominent nucleoli. Occasionally, classic Reed-Sternberg cells are present. Such evidence makes the specimen diagnostic of HD. This experience suggests that sputum cytodiagnosis may be useful adjunctive diagnostic tool in the evaluation of the conditions of patients with HD and pulmonary lesions and may make more invasive diagnostic procedures unnecessary.