Chest wall abscess: An unusual presentation of Hodgkin's lymphoma

Abstract

A chest wall abscess is a very rare presentation of extranodal Hodgkin's lymphoma (HL); only one case has been reported to date. Here, we describe a case of a 38-yr-old man with HL whose initial presentation was a chest wall abscess. The diagnosis of HL was suggested by cytological examination of the purulent discharge and was confirmed subsequently by excisional biopsy of cervical lymph node.

Hodgkin's disease presenting as discharging neck sinuses and a mediastinal mass

“…There have been previous reports of abscess presentations for Hodgkin’s disease and include in the liver,26 lung,27 brain28 and chest wall 29. We found only one report in the literature for suppurative lymphadenitis as the primary presenting feature for Hodgkin’s disease 30…”

Chest wall lymphomas: Fine needle aspiration cytodiagnosis and review of the literature

“…Review of literature corresponding to our 15‐year study period (2000‐2015) revealed 20 reports based either on cases series or isolated cases (Table ) in which 26 histologically confirmed chest wall lymphoma cases were described . Location of the swellings was the anterior chest wall/manubrium in 14 cases, left chest wall (four cases), right chest wall (three cases), lateral chest wall (NOS in two cases), back in one case and rib/chest wall swellings and NOS in two cases.…”

“…Other lymphoma subtypes such as Hodgkin's lymphoma, large anaplastic cell, panniculitis‐like T‐cell lymphoma and Burkitt lymphoma have been reported much less frequently among chest wall swellings. The frequency of lymphomas other than DLBCL from the literature review were as follows: Hodgkin's lymphoma (six cases), Burkitt lymphoma (two cases), ALCL (two cases), and marginal zone B‐cell lymphoma, B‐cell lymphoma (NOS), subcutaneous panniculitis‐like T‐cell lymphoma (SCPTCL), diffuse medium‐size B‐cell lymphoma and null cell NHL in one case each.…”

“…However, the histopathology report was not available in this case. Only six of the 26 chest wall lymphomas from the literature belonging to the review period (2000‐2014) were Hodgkin's lymphoma …”

“…According to Saito et al., chronic tuberculous pyothorax and the development of NHL on the chest wall are believed to be closely related, and cases of malignant lymphoma developing in the chest wall of chronic pyothorax have been increased recently . Tabatabai et al., however, reported two cases of DLBCL presenting as chest wall masses with no history of tuberculous pyothorax; whereas one was a case of end‐stage renal disease, and the other had history of spinal cord ependymoma. Only one of our 11 cases, there was a history of a previous disease and that too renal transplantation.…”