A Rare Case of Hodgkin’s Lymphoma Presenting as Hypereosinophilia

Abstract

Although eosinophilia is a recognised associated feature of Hodgkin’s Lymphoma, hypereosinophilia is seldom the presenting feature in the patient. Here, the authors report an unusual case of a 21-year-old male patient who presented to the General Medicine outpatient department of the hospital with a history of multiple episodes of left-sided pleural effusion in addition to mediastinal and cervical lymphadenopathy. Baseline investigations revealed hypereosinophilia which was persistent despite Diethylcarbamazine (DEC) and steroid therapy. Computer Tomography (CT) guided biopsy of an anterior mediastinal mass, likely to be thymus, led to the diagnosis of Hodgkin's Lymphoma. The patient was transferred to the Haematology department where he was started on Adriamycin, Bleomycin, Vinblastine and Dacarbazine (ABVD) chemotherapy regimen. Despite the fact that blood eosinophilia is an associated finding, it is rare for a patient to present with it. The authors also discuss the discrepancies related to the credibility of eosinophilia as a prognostic marker for Hodgkin’s disease.