Unusual pulmonary hypertension after radiotherapy

Pulmonary hypertension is one of the less well known complications of thoracic irradiation. Furthermore, there are few description of its associations with Hodgkin's lymphoma. An unusual case of pulmonary hypertension is described in a patient of 33, asymptomatic, treated at the age of 8 with radiotherapy until complete cure for a stage 1A sclerotic nodular Hodgkin's lymphoma. This is the 4th case to have developed pulmonary hypertension after Hodgkin's lymphoma but the 1st patient to remain asymptomatic for 25 years. Exposure at such a young age may explain the better compliance to the initial pulmonary and vascular modification induced by thoracic irradiation. The severity of the damage is directly related to the quantity of lung irradiated and to the dose of irradiation. For this reason, the dose and the fields of therapeutic irradiation should be reduced to the minimum. This complication should be suspected in patients who have received thoracic irradiation even when they are asymptomatic, years after radiotherapeutic treatment.