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Postgraduate Education Corner |

Diffuse Ground-Glass Opacities in a Patient With Hodgkin Lymphoma and Progressive Respiratory Failure*

Myrna C. B. Godoy, MD; Daisuke Nonaka, MD; Bruce G. Raphael, MD; Ioannis Vlahos, MD
Author and Funding Information

*From the Departments of Radiology (Drs. Godoy and Vlahos), Pathology (Dr. Nonaka), and Medicine (Hematology) [Dr. Raphael], New York University Medical Center, New York, NY.

Correspondence to: Myrna C. B. Godoy, MD, Department of Radiology, New York University Medical Center, 560 First Ave, IRM 236, New York, NY 10016; e-mail: godoym01@med.nyu.edu


Chest. 2008;134(1):207-212. doi:10.1378/chest.07-2491
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Extract

A 56-year-old man presented with progressive shortness of breath, fever, dry cough, and generalized fatigue for 2 days to an outside institution. His medical history was significant for a parotid tumor resected 5 months earlier. After the procedure, investigations for a persistent fever and weight loss lead to a diagnosis of Hodgkin lymphoma (nodular sclerosing), confirmed by mediastinal node biopsy at mediastinoscopy. He then was treated with ABVD (adriamycin/doxorubicin, 50 mg/m2; bleomycin, 10 U/m2; vinblastine/velban, 6 mg/m2; and dacarbazine, 375 mg/m2) every 2 weeks four times with good response. Hence, the total bleomycin dose was 40 mg/m2. The last dose was administered 12 days before admission. He reported being a former 1 pack per day smoker but denied smoking for the past 6 months. He reported no allergies. During his admission, progressive respiratory failure developed, requiring intubation 5 days after the admission. Following empiric treatment with antibiotics and corticosteroids, the patient’s condition improved and he was extubated after 6 days. He was then transferred to our institution for further management.

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