Sudden death in an adolescent due to undiagnosed classic Hodgkin lymphoma. Issue 1 (9th September 2021)

• Record Type: Journal Article
• Authors: Ogunbona, Oluwaseun B.; Heninger, Michael; Bradley, Kyle; Geller, Rachel
• Is Part Of: Journal of forensic sciences. Volume 67:Issue 1(2022)
• Page Start: 387
• Page End: 390
• Publication Date: 2021-09-09
• Subjects: adolescence -- autopsy -- classic Hodgkin lymphoma -- forensic pathology -- Pax‐5 negative -- sudden death -- undiagnosed malignancy; Medical jurisprudence -- Periodicals; Forensic sciences -- Periodicals; Forensic Medicine -- Periodicals; Gerechtelijke geneeskunde; Gerechtelijke chemie; Gerechtelijke psychiatrie; 363.2505
• DOI: 10.1111/1556-4029.14879
• Languages: English
• ISSNs: 0022-1198

Abstract

Abstract: Few cases of natural sudden death presenting as an undiagnosed lymphoma have been reported in the literature, especially in adolescents. Herein we provide a report of sudden death caused by undiagnosed classic Hodgkin lymphoma (cHL). We describe an 18‐year‐old female who collapsed after several weeks of weight loss, decreased appetite, and dyspnea. At autopsy, a bulky mass arising in the mediastinum and neck compressed the esophagus and trachea, surrounded the great vessels, obliterated the pericardial sac, and infiltrated the myocardium. The lungs were collapsed and large pleural effusions were present. The tumor burden, which weighed at least 2710 g in aggregate, was entirely above the diaphragm. Microscopic examination of the masses showed features typical for nodular sclerosis cHL including large bands of sclerosis, numerous Hodgkin/Reed‐Sternberg (HRS) cells, and an eosinophil‐rich mixed inflammatory cell infiltrate. Immunohistochemical stains showed the HRS cells to be uniformly positive for CD30 and CD15 and negative for CD3, CD20, CD45, and PAX5. This case exemplifies a rare sudden natural death due to previously undiagnosed cHL in a young patient.