Hodgkin's disease rarely involves bones and lungs without causing marked lymph node enlargement. The case of a 36 year old man, who initially presented with vertebral lesions and a solitary nodule in the lung, is reported. At the initial presentation, no apparent lymph node enlargement was observed. Pathological examination of the specimens obtained at vertebral surgery and needle biopsy of the lung suggested a presumptive diagnosis of Histiocytosis X. However, a definite diagnosis of the Hodgkin's disease was made by biopsy of a cervical lymph node which newly enlarged about two years after his initial presentation. This case suggests variability in the clinical feature of Hodgkin's disease.

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