Hodgkin Lymphoma with Hypereosinophilia in a Pediatric Patient: Case Report and Review of the Literature.

Background: Hodgkin lymphoma (HL) comprises 6% of pediatric cancers, showing bimodal incidence in adolescence/young-adult and over 50 years. Characterized by Reed-Sternberg cells, HL is classified as classic/nodular lymphocytic predominant by WHO. Hypereosinophilia (>1500/µL eosinophils) occurs in 15% of HL cases. Case Report: A 17-year-old female presented with weight loss, night sweats, and malaise. Examination showed enlarged lymph nodes, splenomegaly, and palmoplantar erythema. Bloodwork revealed eosinophilia, hypoalbuminemia, high lactic dehydrogenase. Bone marrow confirmed eosinophilic predominance. Lymph node biopsy diagnosed classical HL, nodular sclerosis variant. PET scan identified cervical, mediastinal, abdominal and spleen tumoral activity, classifying her as stage III with high-risk features. OEPA/COPDAC treatment initiated, follow-up PET-CT had mediastinal involvement. She underwent radiotherapy. Conclusion: This rare case illustrates profound hypereosinophilia concomitant with HL. Despite an extensive literature search, no similar hypereosinophilic presentations were found. This case underscores the vital role of considering oncological factors when addressing marked hypereosinophilia in pediatric patients.