Nasopharyngeal classical Hodgkin lymphoma: a case report

BACKGROUND: Hodgkin lymphoma is a malignant lymphoid neoplasm that most commonly originates in lymph nodes, particularly within the cervical, mediastinal, and axillary regions. Extranodal involvement is relatively uncommon, and primary nasopharyngeal Hodgkin lymphoma defines a rare clinical phenomenon. Diagnosis may be delayed because its clinical presentation resembles more common nasopharyngeal conditions. CASE PRESENTATION: A 51-year-old Palestinian woman presented with progressive nasal obstruction and snoring. Endoscopic examination revealed a mass in the nasopharynx. Histopathological analysis confirmed lymphocyte-rich classical Hodgkin lymphoma, staged as IIA. The patient was treated with four cycles of ABVD chemotherapy followed by involved-site radiotherapy using CT simulation with a total dose of 30.6 Gy delivered in 17 fractions, resulting in complete resolution of the lesion. At 12 months of follow-up, the patient remained disease-free with full clinical recovery. CONCLUSION: This case highlights the diagnostic challenges posed by rare extranodal presentations of Hodgkin lymphoma and illustrates the value of maintaining a broad differential diagnosis and performing timely histopathological evaluation in patients with persistent nasal symptoms.