CTICasesUntreated Nodular Sclerosis Hodgkin Lymphoma with De Novo Calcification
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Imaging findings
Chest radiograph and CT scan demonstrate a large, lobulated anterior mediastinal mass associated with right-sided pleural effusion, left-sided supraclavicular lymphadenopathy, and multiple discrete dystrophic calcifications within the mediastinal mass prior to any treatment. Mediastinoscopy and biopsy confirm nodular sclerosis classical Hodgkin lymphoma.
Key takeaways
While calcification in mediastinal Hodgkin lymphoma is typically seen as a late post-therapeutic change, de novo calcification in an untreated, newly diagnosed lymphoma is a rare but well-documented exception to the rule. Core needle biopsies of these masses can occasionally yield non-diagnostic or fibrotic tissue due to the extensive sclerosis, and surgical biopsy may be necessary to secure the diagnosis.
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