A 27-year-old male smoker presented with a six-month history of chest discomfort and hemoptysis. His past medical history was otherwise unremarkable. Tuberculosis and immunodeficiency screenings were negative. An unenhanced chest CT scan revealed a 7-cm mass in the left upper lobe and prevascular lymphadenopathy (Figure 1A). Percutaneous and transbronchial biopsies were inconclusive. Follow-up imaging evidenced an increase in lesion size and central cavitation, as well as new bilateral peribronchial cavitary nodules (Figures 1B-1D). A left upper lobectomy was performed, and histopathological examination of the surgical specimen confirmed the diagnosis of nodular sclerosis Hodgkin lymphoma (Figures 1E and 1F).

 
Primary pulmonary Hodgkin lymphoma (PPHL) accounts for less than 1% of all lymphomas, nodular sclerosis being the most common type.(1,2) Symptoms are nonspecific and may include weight loss, fever, dry cough, and chest discomfort. On imaging, PPHL has a predilection for the upper lobes and may present as unilateral or bilateral parenchymal consolidations or nodules, which may cavitate in about 20% of cases.(1-3) Histological confirmation through incisional biopsy may be challenging because of background inflammation and necrosis, excisional biopsy being frequently required to establish a diagnosis.(3) Therefore, PPHL should be included in the differential diagnosis of otherwise unexplained parenchymal consolidations and cavitary nodules.
 
AUTHOR CONTRIBUTIONS
 
RWM and RSF were directly involved in reporting the CT scans depicted in this article. RWM, FWL, and RSF were equally involved in conceptualizing and supervising the study, as well as in drafting and editing the manuscript. Written consent for publication was obtained from the patient.
 
CONFLICTS OF INTEREST
 
None declared.
 
REFERENCES
 
1.           Chiu WC, Chen SH, Chen BJ, Huang YL, Miserc JS, Wei CH, et al. Primary pulmonary Hodgkin’s lymphoma: A rare etiology mimicking pulmonary tuberculosis. Pediatr Neonatol. 2021;62(5):569-570. https://doi.org/10.1016/j.pedneo.2021.03.017
2.           Tanveer S, El Damati A, El Baz A, Alsayyah A, ElSharkawy T, Regal M. Primary Pulmonary Hodgkin Lymphoma. Rare Tumors. 2015;7(4):5968. https://doi.org/10.4081/rt.2015.5968
3.           Jung H, Kim HS, Han J, Ko YH, Choi YD, Lee T. Clinicopathological Charac-teristics of Primary Pulmonary Hodgkin Lymphoma (PPHL): Two Institution-al Experiences with Comprehensive Literature Review of 115 PPHL Cases. J Clin Med. 2023;12(1):126. https://doi.org/10.3390/jcm12010126