Hodgkin's disease of the lung

The clinical and radiological findings in 16 patients with Hodgkin's disease involving the lung are reviewed. Lung involvement was evident at initial presentation in 11 patients and appeared during the course of the disease in five patients. All the patients had hilar as well as mediastinal lymphadenopathy; most of them--14 of 16--had the nodular sclerosis type of the disease. Patients with these combined findings are apparently more likely to develop lung lesions. Seven of the 11 patients with lung involvement at presentation were symptomatic and received combined chemotherapy in addition to radiotherapy. The lung lesions responded completely in 10 of the 11 patients, and in one they cleared slowly after more than a year of treatment. The question remains open as to whether an asymptomatic patient in the high-risk group, as described above, should receive either adjuvant chemotherapy or radiation therapy to the lung on the prophylactic basis. Our own policy is to add chemotherapy as an adjuvant to female patients and to males who have children.