A 20-year-old male presented with two months history of progressive dyspnea, night sweat, and dry cough. He was admitted due to fever and productive cough for two weeks. Initial investigation showed only marked leukocytosis. Chest radiograph showed right middle lobe opacity and borderline widening mediastinum. He was diagnosed as community acquired pneumonia and treated with board spectrum antibiotics for 10 days. His symptoms improved but he still had orthopnea. Physical examination revealed “central rhonchi” after force inspiration. CT scan of chest demonstrated that a huge anterior mediastinal mass invaded into the tracheal lumen and extended to the right main bronchus. Bronchoscopic findings were intraluminal lobulated endotracheal mass at right anterolateral portion of lower trachea causing near-total obstruction. The cryoablation with tumor removal was performed. The pathology revealed nodular sclerosis and positive immunohistochemistry for CD15, CD30, and PAX-5, compatible with classical Hodgkin’s lymphoma. He was treated with standard chemotherapy with near-complete disease remission after six months follow-up. The present case was a rare presentation of classical Hodgkin lymphoma with endotracheal invasion because most cases presented with external compression rather than intraluminal airway invasion.

Keywords: Hodgkin lymphoma, Endobronchial, Endotracheal, Central rhonchi

Received 5 Jul 2019 | Revised 5 Sep 2019 | Accepted 9 Sep 2019