Hodgkin's disease presenting as a parasternal chest wall mass

A 53 year-old Moroccan woman presented with a tender parasternal mass. Comp uterized tomography showed a mediastinal mass protruding through the sternu m. Cytologic examination of fluid collected from the mass repeatedly showed acute inflammation. Tuberculostatics were started. Since patient did not i mprove on tuberculostatics, a small supraclavicular lymph node was removed. Histologic examination showed Morbus Hodgkin of the nodular sclerosing typ e. Ultimately, cytologic examination of fluid from the parasternal mass sho wed atypical cells. Response on chemotherapy was excellent with complete di sappearance of the parasternal mass. This is a very unusual extranodal pres entation of Hodgkin's disease. (C) 1999 Elsevier Science B.V. All rights re served.