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Free Content A 15-year-old girl with recurrent pneumonia

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Hodgkin's disease (HD) represents a group of lymphomas with distinct clinical and histopathological features that account for 5% of cancers in patients who are <15 years old and 15% in patients who are 15–19 years old. Although the cause of HD is unknown, serologically confirmed infectious mononucleosis has been associated with an increased risk of HD, in addition to its known association with Burkitt's lymphoma. The Reed-Sternberg (RS) cell, a large and multinucleated cell with unique morphology, is the hallmark cell of HD. RS cells are clonal tumor cells that recently have been shown to be derived from B cells originating from germinal centers. Of four histological subtypes of HD, three have a good to excellent prognosis when recognized and treated early. We report a case of HD in a 15-year-old adolescent with a 14-month history of recurrent pneumonia. Open lung biopsy ultimately led to the diagnosis of HD. Although uncommon in this age group, the need to consider the possibility of neoplasm in the setting of recurrent respiratory infection is illustrated in this case. Early diagnosis and intervention may determine the prognosis of such neoplasms.

Keywords: Burkitt's lymphoma; EBV; Epstein-Barr virus; Hodgkin's disease; Reed-Sternberg cell; histiocyte; infectious mononucleosis; lymphadenopathy; lymphoma; recurrent pneumonia

Document Type: Case Report

Affiliations: Division of Allergy and Immunology, Alfred I. duPont Hospital for Children, Nemours Children's Clinic, Wilmington, Delaware; Thomas Jefferson University, Philadelphia, Pennsylvania

Publication date: 01 January 2008

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