Synchronous clear cell renal cell carcinoma and classic Hodgkin lymphoma

Introduction

The coexistence of renal cell carcinoma and classic Hodgkin lymphoma is exceedingly rare, with only two documented cases. Here, we present the third case diagnosed in our institution.

Case presentation

A 46-year-old man presented with right flank pain, fever, mild pancytopenia, and renal mass on computed tomography scan, suggesting renal malignancy. Despite intravenous antibiotics and extensive workup for recurrent fever, his condition did not improve. A bone marrow biopsy revealed rare large EBV-positive B cells. Surprisingly, imaging only showed minimal intraabdominal lymphadenopathy in the perinephric region. Subsequent surgery confirmed clear cell renal cell carcinoma in the kidney and scattered large, atypical cells consistent with classic Hodgkin lymphoma in the suprahilar lymph node.

Conclusion

This case presents a rare case of classic Hodgkin lymphoma occurring in the perirenal region. When clinicians encounter unexplained symptoms in patients with primary tumors, additional biopsies should be considered for possible secondary malignancy.