Authors :
Kirtick Poovendran; Omar Mirza Baig; Mohammad Ibrahim Hashmi; Mohammad Umar Khan; Sidra Izhar
Volume/Issue :
Volume 11 - 2026, Issue 1 - January
Google Scholar :
https://tinyurl.com/ys4cc3vf
Scribd :
https://tinyurl.com/5ysf5ekj
DOI :
https://doi.org/10.38124/ijisrt/26jan296
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Abstract :
Back Ground
Hodgkin lymphoma (HL) is a rare B-cell malignancy mostly present in adolescents or young adults with patients
noticing a painless lump in the neck. It usually starts infecting locally usually involving one lymph node which then spreads
to nearby lymph nodes, infecting a larger area commonly involving the cervical region and the mediastinal region with only
20–30% of patients experiencing systemic “B” symptom
Case Presentation
A 43-year-old male presented with multiple painless cervical and bilateral supraclavicular lymph node swellings of 1.5
years’ duration, with a history of slow progression over the past 10 years. There were no constitutional symptoms or
significant comorbidities, and systemic examination was unremarkable. Local examination revealed multiple non-tender,
discrete lymph nodes with normal overlying skin. Excision biopsy of a right cervical lymph node confirmed bilateral cervical
lymphadenopathy, with Hodgkin’s lymphoma considered as a possible diagnosis.
Management And Outcome
The patient was admitted for evaluation of chronic bilateral cervical and supraclavicular lymphadenopathy. Following
clinical assessment and investigations, an excision biopsy of the right cervical lymph node was performed under general
anesthesia. Postoperatively, the patient received antibiotics, analgesics, and supportive care with close monitoring. The
postoperative course was uneventful, and the patient was discharged with follow-up advice.
Discussion
Hodgkin’s lymphoma is a B-cell malignancy that commonly presents with painless cervical and supraclavicular
lymphadenopathy, predominantly affecting young adult males and accounting for approximately 11% of all lymphomas.
Diagnosis requires excision biopsy demonstrating characteristic Reed–Sternberg cells with supportive immunophenotyping,
as fine-needle aspiration is often inadequate. Clinical staging is performed using the Ann Arbor system, which guides
prognosis and management. Despite excellent survival outcomes with modern therapy, atypical indolent presentations
without B symptoms require careful histopathological confirmation.
Conclusion
This case highlights the diagnostic challenge of long-standing painless cervical lymphadenopathy with supraclavicular
involvement. The absence of constitutional symptoms with progressive nodal enlargement raised suspicion of Hodgkin’s
lymphoma. Excision biopsy was essential for definitive diagnosis, underscoring the importance of histopathological
evaluation in persistent lymphadenopathy.
References :
- Gaddey, H. L., & Riegel, A. M. (2016). Unexplained Lymphadenopathy: Evaluation and Differential Diagnosis. American family physician, 94(11), 896–903. Link - https://pubmed.ncbi.nlm.nih.gov/27929264/
- Bassiouni, M., Kang, G., Olze, H., Dommerich, S., & Arens, P. (2021). The diagnostic yield of excisional biopsy in cervical lymphadenopathy: A retrospective analysis of 158 biopsies in adults. Ear Nose & Throat Journal, 102(10), 645–649. https://doi.org/10.1177/01455613211023009
- Kaseb, H., & Babiker, H. M. (2023, June 26). Hodgkin lymphoma. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK499969/#:~:text=Hodgkin%20lymphoma%C2%A0is%20a%20rare%20malignancy,is%20as%20follows%3A%20nodular%20sclerosis
- Wang, H., Balakrishna, J. P., Pittaluga, S., & Jaffe, E. S. (2018). Diagnosis of Hodgkin lymphoma in the modern era. British Journal of Haematology, 184(1), 45–59. https://doi.org/10.1111/bjh.15614
- Sakr, M. (2016). Cervical: lymphadenopathy. Pubmed, 163–190. https://doi.org/10.1007/978-3-319-27532-1_8
- Kaseb, H., & Babiker, H. M. (2023, June 26). Hodgkin lymphoma. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK499969
- Küppers, R., 1. (2025). Advances in Hodgkin lymphoma research. In Trends in Molecular Medicine (Vol. 31, Issue 4, pp. 326–326). https://doi.org/10.1016/j.molmed.2024.10.004
- Mottok, A., & Steidl, C. (2018). Biology of classical Hodgkin lymphoma: Implications for prognosis and novel therapies. Blood, 131(15), 1654–1665. https://doi.org/10.1182/blood-2017-09-772632
9. Maheshwari, A., Padhy, R. K., & Dash, B. K. (2015). A CLINICOPATHOLOGICAL STUDY OF CERVICAL LYMPHADENOPATHY. Journal of Evolution of Medical and Dental Sciences, 04(19), 3497–3507. https://doi.org/10.14260/jemds/2015/504
Back Ground
Hodgkin lymphoma (HL) is a rare B-cell malignancy mostly present in adolescents or young adults with patients
noticing a painless lump in the neck. It usually starts infecting locally usually involving one lymph node which then spreads
to nearby lymph nodes, infecting a larger area commonly involving the cervical region and the mediastinal region with only
20–30% of patients experiencing systemic “B” symptom
Case Presentation
A 43-year-old male presented with multiple painless cervical and bilateral supraclavicular lymph node swellings of 1.5
years’ duration, with a history of slow progression over the past 10 years. There were no constitutional symptoms or
significant comorbidities, and systemic examination was unremarkable. Local examination revealed multiple non-tender,
discrete lymph nodes with normal overlying skin. Excision biopsy of a right cervical lymph node confirmed bilateral cervical
lymphadenopathy, with Hodgkin’s lymphoma considered as a possible diagnosis.
Management And Outcome
The patient was admitted for evaluation of chronic bilateral cervical and supraclavicular lymphadenopathy. Following
clinical assessment and investigations, an excision biopsy of the right cervical lymph node was performed under general
anesthesia. Postoperatively, the patient received antibiotics, analgesics, and supportive care with close monitoring. The
postoperative course was uneventful, and the patient was discharged with follow-up advice.
Discussion
Hodgkin’s lymphoma is a B-cell malignancy that commonly presents with painless cervical and supraclavicular
lymphadenopathy, predominantly affecting young adult males and accounting for approximately 11% of all lymphomas.
Diagnosis requires excision biopsy demonstrating characteristic Reed–Sternberg cells with supportive immunophenotyping,
as fine-needle aspiration is often inadequate. Clinical staging is performed using the Ann Arbor system, which guides
prognosis and management. Despite excellent survival outcomes with modern therapy, atypical indolent presentations
without B symptoms require careful histopathological confirmation.
Conclusion
This case highlights the diagnostic challenge of long-standing painless cervical lymphadenopathy with supraclavicular
involvement. The absence of constitutional symptoms with progressive nodal enlargement raised suspicion of Hodgkin’s
lymphoma. Excision biopsy was essential for definitive diagnosis, underscoring the importance of histopathological
evaluation in persistent lymphadenopathy.