Case 20-1978: Progressive Dyspnea and Anasarca Eight Years after Treatment of Hodgkin's Disease

Presentation of Case A 58-year-old man was admitted to the hospital because of dyspnea and anasarca. He was well until eight years previously, when an enlarged right cervical lymph node was found. Examination was otherwise negative. An x-ray film of the chest (Fig. 1) demonstrated widening of the right superior mediastinum and slight elevation of the right hemidiaphragm. An intravenous pyelographic examination showed calcified mesenteric lymph nodes; the spleen appeared slightly enlarged; the right kidney was normal in size and configuration; a rounded mass, 8 cm in diameter, projected from the lower pole of the left kidney and distorted the.