Advanced Stage IVb Classical Hodgkin’s Lymphoma in a 9/11 First Responder: The Persistent Health Risks and Impact of Environmental Exposures

This case report details the clinical journey of a first responder from the events of 9/11 who presented with significant B symptoms and right hip pain, ultimately diagnosed with stage IVb classical Hodgkin's lymphoma with extensive metastasis. Imaging revealed a right proximal femoral mass, mediastinal and supraclavicular nodal metastases, and multiple hypermetabolic splenic masses, emphasizing the aggressive nature of the disease and the importance of early detection and prompt management. Following referral to an oncologist, the patient was treated with six cycles of the chemotherapy regimen consisting of brentuximab plus doxorubicin, vinblastine, and decarbazine (brentuximab-AVD) without the need for surgical excision. A follow-up PET/CT scan seven months after diagnosis showed no active tumors, indicating that the patient was in remission. Three years following the initial diagnosis, the patient displays no signs of recurrence and continues to remain B-symptom-free. He does report lingering intermittent and stable right hip pain managed with medications as needed.