Unusual presentation of Hodgkin lymphoma.

A 43-year old woman was admitted to our hospital because of sighing dyspnoea and rhinitis. On admission, a rhinoscopy revealed a soft tissue mass on posterior wall of nasopharynx; at physical examination neither epatosplenomegaly nor lymphadenopathy were present. All laboratory data were within normal range. A cranial CT scan showed a large mass (-> 2,5-3 cm) with polypoid aspect on posterior wall of rhinopharynx without maxillary osteolysis (Figure 1). CT scans of chest and abdomen were normal as well as the bone marrow biopsy. A diagnosis of Hodgkin disease, subtype lymphocyte predominance, was made after an agobiopsy of the rhinopharynx's mass: within a background of small lymphocytes and histiocytes, the high magnification showed variant lymphocytic and histiocytic cells with popcorn nuclei (Figure 2a,b). The patient was succesfully treated with chemotherapy (4 cycles according to ABVD regimen) and radiotherapy.