Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2019; 7(17): 2513-2518
Published online Sep 6, 2019. doi: 10.12998/wjcc.v7.i17.2513
Atypical cutaneous lesions in advanced-stage Hodgkin lymphoma: A case report
Fulvio Massaro, Angela Ferrari, Enrico Zendri, Magda Zanelli, Francesco Merli
Fulvio Massaro, Angela Ferrari, Francesco Merli, Hematology, Azienda Unità Sanitaria Locale IRCCS di Reggio Emilia, Reggio Emilia 42123, Italy
Enrico Zendri, Magda Zanelli, Azienda Unità Sanitaria Locale IRCCS di Reggio Emilia, Reggio Emilia 42123, Italy
Author contributions: All authors contributed to the manuscript’s preparation.
Informed consent statement: Written informed consent was obtained from the patient for publication of clinical data and accompanying images.
Conflict-of-interest statement: The authors reported no potential conflicts of interest regarding this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016) and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Fulvio Massaro,MD, Arcispedale Santa Maria Nuova, UOC of Haematology, Azienda Unità Sanitaria Locale IRCCS di Reggio Emilia, viale Risorgimento 80, Reggio Emilia 42123, Italy.fulvio.massaro@ausl.re.it
Telephone: +39-52-2296111 Fax: +39-52-2335200
Received: May 13, 2019
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
Processing time: 119 Days and 5.4 Hours
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

Skin involvement in HL is a rare finding and may represent a challenging clinical presentation due to extremely various types of lesions observed.

Keywords: Hodgkin lymphoma; Skin lesions; Advanced stage; ABVD; Case report

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.