Nodular Sclerosis Hodgkin Lymphoma Presenting as Widespread Necrotic Lymphadenopathy: A Case Emphasizing Diagnostic Pitfalls

Hodgkin lymphoma (HL) most commonly presents with painless, rubbery lymphadenopathy, whereas necrotic nodes are rare and frequently misattributed to infectious or metastatic etiologies. We report the case of a 44‑year‑old man with widespread necrotic lymphadenopathy involving cervical, abdominal, pelvic, and inguinal regions. Histopathology confirmed nodular sclerosis HL (NSHL) with CD30+/CD15+ Reed–Sternberg cells. The patient achieved complete remission following six cycles of ABVD chemotherapy. This case underscores the diagnostic pitfalls of necrotic lymphadenopathy, particularly in tuberculosis‑endemic regions, and highlights the importance of early excisional biopsy and immunohistochemistry for accurate diagnosis and timely treatment.