22962              HODGKIN’S DISEASE WITH PULMONARY INVOLVEMENT

Two and a half years before his death this 52-year old man was found to be suffering from atypical Hodgkin’s disease.  He presented with increasing weakness, lassitude, exertional dyspnoea, peripheral oedema and night sweats.  He was anaemic and had hepatosplenomegaly and anterior cervical lymphadenopathy.  The anaemia was haemolytic in nature and required repeated transfusions.  The primary disease was treated with cytotoxic agents.  His condition remained stable till two months before death when he began to deteriorate.  Death was caused by septicaemia and peritonitis.

The specimen is part of the right lung showing massive consolidation of the medial two-thirds of the lower lobe.  The cut surface shows pale fleshy tissue with some areas of yellow necrosis and a few areas of haemorrhage.  There is a similar area of infiltration at the tip of the middle lobe.  Histology shows diffuse sheets of large reticulum-type cells and a few Reed-Sternberg cells in the enlarged lymph nodes.  This lymphomatous tissue forms the cellular component of a diffuse intra-alveolar exudate in the lung, embedded in fibrinous fluid.  Polymorphs are very scanty.  There are large necrotic areas in the section.