What is commonly seen as the initial presentation of Hodgkin lymphoma?

• A. Painless lymphadenopathy, often with mediastinal involvement
• B. Acute kidney injury
• C. Severe epistaxis
• D. Pancreatitis

Answer: (A)

Hodgkin lymphoma most often begins with painless swelling of lymph nodes, especially in the neck, and may involve the mediastinal nodes so that a mediastinal mass is seen on imaging. This presentation—painless lymphadenopathy with possible mediastinal involvement—fits the typical early picture of the disease. Many patients do not have symptoms beyond enlarging nodes, though some may develop B symptoms like fever, night sweats, and weight loss as the disease progresses. The other options—acute kidney injury, severe epistaxis, or pancreatitis—are not common initial presentations of Hodgkin lymphoma and would suggest different diagnoses or conditions.