Abstract:

Classical Hodgkin lymphoma (CHL) accompanied by bone destruction and abscess formation is clinically rare and easily misdiagnosed as an infectious disease. This article reports a case of CHL in a young male patient presenting primarily with pulmonary infiltration, sternal destruction, and abscess formation, aiming to explore its clinical features and diagnostic approach to reduce misdiagnosis. The patient was a young male who initially presented with cough and chest pain. Imaging findings suggested left upper lung infiltration, sternal bone destruction, mediastinal mass, and possible left anterior chest wall abscess. Multiple etiological examinations failed to confirm an infectious origin, and both anti-infective therapy and diagnostic anti-tuberculosis treatment showed poor efficacy. The diagnosis was ultimately confirmed by pathological examination of a left supraclavicular lymph node biopsy as CHL (immunohistochemistry: CD30 positive, CD15 positive, PAX5 weakly positive). After standardized treatment, the lesions completely resolved. This case suggests that lymphoma should be considered in patients with bone destruction and abscess formation who present with suspected infection but lack etiological evidence and respond poorly to treatment.

Key words: Hodgkin disease, Lymphoma, Sternum, Osteonecrosis, Abscess, Lung diseases