Hodgkin’s Disease and Pericardial Effusion
The present study reports a case of a young male patient, 22 years old, with a previous diagnosis of Hodgkin’s lymphoma who presented for two weeks with dyspnea complaints with minimum efforts, a continuous chest pain on pressure, dysphagia, sporadic palpitations, and dry cough with fever episodes not measured. Physical exam revealed presence of fever, bibasal pulmonary crackles in respiratory auscultation, increased jugular venous pulse, and hypotension associated with paradoxical pulse, and hypotension associated with paradoxical pulse were found. No more pathological finding was noticed.
Image exams were essential to conclude diagnosis. The chest radiograph demonstrated right perihilar thickening, linear atelectasis of the lower third of the right lung, convex diaphragm, free costophrenic sinus, and enlarged cardiac silhouette – mainly the left ventricular arch, elongated aorta. Transthoracic echocardiogram shows significant pericardial effusion with diastolic restriction and left ventricular ejection fraction 62%. The chest computed tomography shows in mediastinal region a lymphadenomegaly in pre-vascular and pre-tracheal chains and mediastinal vessels permeable and with normal dimensions. There is an extensive pericardial effusion. In the pleuropulmonary region was seen an atelectasis of the lower lobe of the right lung, moderate right pleural effusion, and small left pleural effusion and fibrotic aspect of veiling in the medial segment of the middle lobe of the right lung.