Hodgkin lymphoma (pulmonary manifestations)

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 .