Achalasia and Hodgkin's disease: a chance association?

We report a patient with a case of Hodgkin's disease, stage IIB, presenting as achalasia. Not only did careful evaluation fail to reveal tumor involvement of the esophagus, but therapy of the Hodgkin's disease failed to improve and, in fact, worsened the dysphagia. Pneumatic dilatation was required after completion of radiation therapy. We still need to evaluate dysphagia in patients with lymphoma by standard means, despite reports of "secondary" achalasia.