Fig. 23.

Nodular sclerosis Hodgkin lymphoma in a 44-year-old woman. Frontal chest radiograph shows a large, well-defined mediastinal mass with increased density (arrow). Contrast-enhanced CT scan shows a bulky soft tissue mass (arrows) with homogeneous CT-attenuation value occupying prevascular space. Note the left internal mammarian artery completely surrounded by the lesion. Photomicrograph reveals numerous neoplastic lacunar cells (arrows) in a background of small lymphocytes, histiocytes and eosinophils, which supports the diagnosis of nodular sclerosis type Hodgkin lymphoma