Primary Extranodal Classical Hodgkin Lymphoma of the Sphenoid Sinus: A Case Report and Brief Review of the Literature

Abstract

Primary sinonasal lymphoma is a relatively rare disease, particularly in Western societies, and the vast majority of these are non-Hodgkin lymphoma. Classical Hodgkin lymphoma (CHL) characteristically originates in lymph nodes; primary extranodal CHL of the sinonasal tract is extremely rare. We report a case of a 63-year-old woman with primary CHL of the sphenoid sinus. The patient presented to the emergency department with complaints of “flashing light” in both eyes. Magnetic resonance imaging studies revealed a 4.2-cm enhancing mass in the sphenoid sinus. Histologic examination of the sphenoid mass revealed a diffuse mixed inflammatory infiltrate, within which were scattered large atypical cells with enlarged nuclei with irregular nuclear contours and prominent eosinophilic nucleoli, consistent with Hodgkin/Reed-Sternberg cells. Immunohistochemical studies showed the large atypical cells to be positive for CD15 and CD30 and negative for CD20 and CD45. In situ hybridization staining for small Epstein-Barr virus–encoded RNA was also positive in the atypical cells. These findings supported the diagnosis of CHL.