Hodgkin lymphoma (pulmonary manifestations)

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Pulmonary manifestations of Hodgkin lymphoma are relatively rare, present in 5-12% of patients at the time of diagnosis. It is relatively more common with the nodular sclerosing subtype. Pulmonary involvement usually indicates stage IV disease.

Radiographic features

Bilateral involvement is seen in ~4% of cases .

Peribronchial infiltration may sometimes be seen . This may manifest as direct extension from hilar nodes, or as small peripheral nodules, which may or may not be cavitating. Other patterns include:

masses
mass-like consolidation
diffuse interstitial thickening

Lung involvement without mediastinal nodal involvement is extremely rare in primary disease. In recurrent disease pulmonary parenchymal involvement is more common, and may occur without nodal enlargement .