Primary pulmonary Hodgkin disease. Case report

Abstract

Introduction: among malignant diseases of the lymphatic system Hodgkin disease is distinguished by its frequent appearance in the age group of 15 to 30 years, with a peak presentation in adults up to 55 years. Although it rarely affects extralymphatic structures, lung involvement is common (occurs in 15-40 % of cases). However the primary pulmonary Hodgkin disease is extremely rare (less than 100 cases are reported annually); it is defined as the involvement of the lung without extrathoracic commitment, mediastinal mass or involvement of bone marrow for, at least, three months from diagnosis.

Case report: male patient, white, 45 years old, smoker with a history of alcoholism, who presented breathlessness twenty days prior to admission to the Ward of Internal Medicine at the General Teaching Hospital "Roberto Rodríguez Fernández" of Morón. He was diagnosed with malignant lung disease, concomitant with community-acquired respiratory infection; cytology gave as result a primary pulmonary Hodgkin disease. Were planned eight cycles of treatment with a scheme based in doxorubicin, vinblastine, bleomycin and dacarbazine, without radiation therapy.

Conclusions: the patient responded well to chemotherapy and had a favorable outcome to the third cycle, when he decided to abandon the treatment; two months later he died of cerebral fungal sepsis. The patient received the standard treatment (chemotherapy and radiotherapy combined); radiotherapy was excluded because the presentation of the case was pleural effusion, without criteria for its realization.