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Hodgkin Lymphoma : Extranodal Sites

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Extranodal Involvement in Classic Hodgkin lymphoma (cHL): cHL is a node-based disease in most cases. In advanced stages, there is frequent secondary involvement of spleen, bone marrow, liver and many other sites. In uncommon cases, it can present at any organ or site as a primary disease.

Thymus is frequently involved in patients with bulky mediastinal disease and can mimic primary thymic neoplasm. The involved thymus often shows cystic degeneration.

Lung is one of the most frequently affected non-lymphoid organs, usually as an extension of mediastinal involvement. Primary cHL of lung is extremely rare.

Mucosa-associated lymphoid tissues, such as tonsils and Waldeyer's ring, are rarely involved as primary sites in cHL.

Primary cHL of gastrointestinal tract is uncommon and would need to be separated from EBV-associated lymphoproliferative disorder with Hodgkin-like features.

Primary cHL of skin is difficult to diagnose accurately due to its rarity and morphologic overlap with CD30-positive lymphoproliferative neoplasms such as anaplastic large cell lymphoma and lymphomatoid papulosis.

About this image: Classic Hodgkin lymphoma, nodular sclerosis subtype, involving spleen. Image courtesy of Dr. Jean-Christophe Fournet, Paris, France; humpath.com; Used with permission

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