Hodgkin's Lymphoma (HL) Presenting As An Abnormal Mammogram: A Case Report

Although not a common presentation, Hodgkin's lymphoma (HL) can first manifest as an enlarged axillary lymph node. We report a case of a patient diagnosed with nodular sclerosing HL, presenting as an abnormal axillary lymph node incidentally noted during routine mammogram.

A 79 year-old asymptomatic female was referred to our center after being discovered a 3 cm left axillary lymph node detected during a routine screening mammogram. Except from the enlarged left axillary lymphadenopathy, the remaining physical exam was within normal limits. An ultrasound-guided fine needle biopsy revealed histologic features consistent with Hodgkin's lymphoma, nodular sclerosing type. Immunostains confirmed the presence of Reed Sternberg cells that were positive for CD 30, focally positive for CD 15, and negative for CD 20 and EMA. Bilateral bone marrow showed no evidence of HL involvement. A positron-emission tomography detected abnormal uptake in multiple enlarged lymph nodes above and below the diaphragm, and in the thoracic spine, at T9, T11 and T12 vertebral body levels. The patient was successfully treated with doxorubicin-based combination chemotherapy regimen.

There are multiple clinical presentations for Hodgkin's lymphoma. Routine mammograms can aid in the detection of cancer types other than breast cancer.

No relevant conflicts of interest to declare.