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A 35-year-old man presented with fever, drenching sweats, severe shoulder pain, and bilateral cervical and supraclavicular lymphadenopathy on physical exam. Computed tomography of the chest showed hilar, mediastinal, and supraclavicular adenopathy, multiple pulmonary nodules, and a left-sided pleural effusion. Thoracentesis revealed a green pleural effusion. After a systematic workup and core biopsy analysis of a supraclavicular lymph node, the patient was diagnosed with Hodgkin lymphoma. The green pleural effusion fluid was attributed to increased pleural fluid viscosity rarely seen in patients with lymphoma.
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Gutierrez-Gamez et al. (2024) studied this question.
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