# Unusual bilateral lymphadenopathy revealing Hodgkin’s lymphoma: a case report

## TL;DR

A 72-year-old man with unusual swollen lymph nodes was diagnosed with Hodgkin’s lymphoma after a biopsy revealed Reed-Sternberg cells.

## Contribution

Highlights the importance of timely biopsy in diagnosing Hodgkin’s lymphoma in regions where tuberculosis is common.

## Key findings

- Persistent bilateral lymphadenopathy without constitutional symptoms led to a Hodgkin’s lymphoma diagnosis.
- Excisional biopsy confirmed classical Hodgkin lymphoma with Reed-Sternberg cells in an inflammatory background.
- Early biopsy and evaluation are critical to avoid diagnostic delays in lymph node malignancies.

## Abstract

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.