Published online Sep 6, 2019. doi: 10.12998/wjcc.v7.i17.2513
Peer-review started: May 14, 2019
First decision: May 30, 2019
Revised: July 15, 2019
Accepted: July 27, 2019
Article in press: July 27, 2019
Published online: September 6, 2019
Cutaneous involvement in Hodgkin lymphoma (HL) is a rare finding. Few cases have been reported in literature, most describing paraneoplastic manifestations. Only very few papers have described primary HL skin infiltration, reporting a wide range of clinical presentations that frequently include ulcers; plaques, nodules and papules have also been noticed.
We report the case of a 56-year-old man who presented fever, multiple adenomegalies of neck and axilla and thick serpiginous skin lesions involving bilateral pectoral regions. After an initial diagnostic workup for a suspected active infectious disease, a lymph node biopsy was performed, which showed a neoplastic invasion from a mixed cellularity classical HL. The same histological pattern was described in a cutaneous biopsy of the chest lesions. The other staging procedures performed revealed an advanced disease, with unfavourable clinical prognostic features. The patient was prescribed 6 cycles of ABVD chemotherapy scheme (doxorubicin, bleomycin, vinblastine, dacarbazine), a regiment that requires demonstration of metabolic response achievement at the interim PET/CT scan to confirm continuation or to change therapeutic strategy.
Skin involvement in HL is a rare finding and may represent a challenging clinical presentation due to extremely various types of lesions observed.
Core tip: We report the case of a 56-year-old man presenting with neck and armpits swelling, fever and thick cutaneous chest lesions. Active infectious disease was ruled out and a lymph node biopsy was carried out, diagnostic for Hodgkin lymphoma (HL). Histological examination of pectoral cutaneous serpiginous plaques resulted positive for the same haematological malignancy infiltration. Skin involvement in HL is a rare finding, with main clinical manifestations being ulcers, papules and nodules. We describe this peculiar finding to underline the need for a correct differential diagnosis, especially for other malignancies and infectious disorders.