A Challenging Case of Hodgkin Lymphoma Mimicking Tuberculosis in a Young Female Patient: A Case Report

Hodgkin lymphoma (HL) is a rare malignancy. Distinguishing between Hodgkin lymphoma and tuberculosis (TB) is challenging. A 22-year-old patient had been undergoing treatment for lymph node tuberculosis (TB) for 18 months based on the histological examination of cervical lymphadenopathy. The patient presented with neurological signs suggestive of spinal cord compression, prompting MRI and CT of the chest, abdomen, and pelvis (CT CAP) to investigate a potential neoplastic origin. The CT CAP scan revealed infiltration of the left supraclavicular and lateral cervical regions. An ultrasound-guided biopsy of the infiltrated area was performed, and the histological and immunohistochemical findings were consistent with stage IV classic Hodgkin lymphoma. Epithelioid granulomas with caseous necrosis are not exclusive to TB; lymphoma should also be considered in this context, and immunohistochemical analysis should be performed for an accurate diagnosis.