摘要：

Primary Pulmonary Hodgkin's Lymphoma (PPHL) without hilar node involvement is exceedingly rare. We report a case of a 41-year old female who presented with 11-month history of dry cough, and persistent mass-like consolidation in the left lung with- out hilar lymphadenopathy despite appropriate antibiotic treatment. The initial transbronchial biopsy was inconclusive, and a second CT guided transthoracic biopsy revealed a diagnosis of Hodgkin's lymphoma. Accurate interpretation of imaging and pathology is important in the management of PPHL as it can mimic an infection or non-hematopoietic neoplastic process.Case DescriptionA 41-year-old lady, otherwise healthy, was presented to her Primary Care Physician with an11-month history of non-pro- ductive cough and left thoracic rib pain. She had no fevers, chills or night sweats. A chest radiograph revealed a 5 cm area of mass- like consolidation within her left lung, and she was treated with a course of antibiotics. A repeat chest radiograph obtained after two weeks of antibiotic treatment showed persistent left lung mass-like consolidation. Her laboratory studies showed: white blood cell count 15,100 cells/µL (differential: neutrophil 80% and lymphocytes 7%), hemoglobin concentration 11.4 g/dl, mean corpuscular volume of 94.9 fl, platelet count 321,000 cells/µL. The erythrocyte sedimentation rate was 34 mm/h (reference range, 0 - 10 mm/h), and the C-reactive protein was 0.4mg/dl. A CT scan was performed and revealed left upper lobe mass with internal air bronchograms with mediastinal lymphadenopathy. There was no evidence of hilar lymphadenopathy. PET CT was also performed, which revealed high FDG avidity of the left upper lobe mass and mediastinal lymphadenopathy (Figure 1). A transbronchial biopsy was performed, and it was non-diagnostic.

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