HODGKIN’S LYMPHOMA MASQUERADING AS CRYPTOGENIC ORGANIZING PNEUMONIA: A DIAGNOSTIC CHALLENGE

Abstract

A 27-year-old woman presented with persistent cough, intermittent fever, and dyspnea. Initial imaging revealed right lower lobe consolidation. Despite empirical antibiotics, symptoms persisted. Extensive infectious workup and bronchoscopy were non-contributory. A CT-guided lung biopsy suggested cryptogenic organizing pneumonia (COP), and corticosteroid therapy led to transient improvement. However, the recurrence of symptoms post tapering steroids due to steroid-related side effects prompted further investigation. A PET-CT scan revealed metabolically active hilar and mediastinal lymphadenopathy. EBUS-guided cryobiopsy of a right hilar node confirmed Hodgkin’s lymphoma. The patient was started on CHOP chemotherapy and is currently improving. This case highlights how Hodgkin’s lymphoma can mimic organizing pneumonia and underscores the importance of re-evaluating the diagnosis when clinical progression diverges from the expected course, even after initial tissue sampling.