A Case Study of 43 Year Old Male with Bilateral Cervical Lymphadenopathy: A Detail Discussion and Management

Back Ground Hodgkin lymphoma (HL) is a rare B-cell malignancy mostly present in adolescents or young adults with patients noticing a painless lump in the neck. It usually starts infecting locally usually involving one lymph node which then spreads to nearby lymph nodes, infecting a larger area commonly involving the cervical region and the mediastinal region with only 20–30% of patients experiencing systemic “B” symptom  Case Presentation A 43-year-old male presented with multiple painless cervical and bilateral supraclavicular lymph node swellings of 1.5 years’ duration, with a history of slow progression over the past 10 years. There were no constitutional symptoms or significant comorbidities, and systemic examination was unremarkable. Local examination revealed multiple non-tender, discrete lymph nodes with normal overlying skin. Excision biopsy of a right cervical lymph node confirmed bilateral cervical lymphadenopathy, with Hodgkin’s lymphoma considered as a possible diagnosis.  Management And Outcome The patient was admitted for evaluation of chronic bilateral cervical and supraclavicular lymphadenopathy. Following clinical assessment and investigations, an excision biopsy of the right cervical lymph node was performed under general anesthesia. Postoperatively, the patient received antibiotics, analgesics, and supportive care with close monitoring. The postoperative course was uneventful, and the patient was discharged with follow-up advice.  Discussion Hodgkin’s lymphoma is a B-cell malignancy that commonly presents with painless cervical and supraclavicular lymphadenopathy, predominantly affecting young adult males and accounting for approximately 11% of all lymphomas. Diagnosis requires excision biopsy demonstrating characteristic Reed–Sternberg cells with supportive immunophenotyping, as fine-needle aspiration is often inadequate. Clinical staging is performed using the Ann Arbor system, which guides prognosis and management. Despite excellent survival outcomes with modern therapy, atypical indolent presentations without B symptoms require careful histopathological confirmation.  Conclusion This case highlights the diagnostic challenge of long-standing painless cervical lymphadenopathy with supraclavicular involvement. The absence of constitutional symptoms with progressive nodal enlargement raised suspicion of Hodgkin’s lymphoma. Excision biopsy was essential for definitive diagnosis, underscoring the importance of histopathological evaluation in persistent lymphadenopathy.