Primary Hodgkin's disease of the thymus

The thymus is a lymphoid organ located in the antero-superior mediastinum and composed of heterogeneous admixture of lymphoid and epithelial elements. Thymic tumors are dominated by thymoma; lymhomas are uncommon involving the gland secondary to adenopathies. Primary thymic lymphomas are exceptional.

We report a 25-year-old man referred to us because of chest pain and irritating cough since 2 months. Physical examination was normal and no lymph nodes were palpable. Chest radiography showed an anterior mediastinal mass. Computed tomography (CT) examination of the chest revealed a homogeneous tissular mass occupying the anterior mediastinum in its upper and medium stage, extending to the infundibulum without lymph node enlargement. Thymectomy and wedge were performed via a median sternotomy. Pathologic diagnosis was nodular sclerosis Hodgkin's disease of the thymus. The patient received 6 cycles of ABVD (Adriamycin [doxorubicin], bleomycin, vinblastin and dacarbazine) and mediastinal radiotherapy. Currently, tow years after diagnosis, he is well and free of disease.

Primary thymic Hodgkin's lymphoma is a rare entity which should be included in the differential diagnosis of anterior mediastinal mass especially in young patients.