Lymphocyte Depleted Hodgkin's Lymphoma Presented with Haemolytic Anemia: A Case Report and Literature Review.

Hodgkin's lymphoma accounts for ten per cent of all lymphomas. Lymphomas represent the third most frequent neoplasia on a worldwide scale and constitute 3 % of malignant tumors. In the United States, there are about 8,000 new cases every year. This case report describes a case of lymphocyte-depletion Hodgkin's lymphoma (LDHL) manifested by anemia. LDHL is the least common of the types of Hodgkin's disease, comprising less than 1 % of all cases of this cancer. A 19-year-old Indian male presented with complaint of huge asymptomatic swelling in the right lateral part of neck since 8 months. All the lymph nodes of the right side submandibular, submental, cervical and axillary lymph nodes were rubbery in consistency, tender and were palpable. The CBC revealed hemoglobin of 7.4 gm/dL and ESR count was highly raised up to 125 mm/first hour. Direct Coomb's test detected multiple antibodies IgG type, which was consistent with the diagnosis of Haemolytic anemia. Ultrasonography of the neck showed enlarged discrete lymph nodes on the right side of the neck. For further evaluation patient was subject for ultrasonography of the abdomen which revealed there was of enlargement of both spleen and liver. Lymph node FNAC revealed classic LDHL. Anemia and swelling resolved after completion of chemotherapy with adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) after 6 cycles. The literature review and our case report discuss the optimal management of this Hodgkin's lymphoma. To our knowledge, this is the first case of LDHL with Haemolytic Anemia treated with only ABVD regime.