A 20-year-old Japanese man presented with a 4-month history of progressive fatigue, fever, cervical lymphadenopathy and oedema. Physical examination showed bilateral cervical, axillary, mediastinal and inguinal lymphadenopathy and gynecomastia (top left, computed tomography). The white blood cell count was 12Æ9 · 10/l, haemoglobin concentration 10Æ5 g/dl and platelet count 719 · 10/l. The serum lactate dehydrogenase and C-reactive protein levels were 602 IU/l and 156Æ3 mg/l respectively. Plasma levels of interleukin 6 (IL-6) and vascular endothelial growth factor (VEGF) were elevated to 446 pg/ml (normal <4Æ0 pg/ml) and 1710 pg/ml (normal range, 62–707 pg/ml) respectively. A right cervical lymph node biopsy showed nodular sclerosing Hodgkin’s disease (top right). Immunoperoxidase staining showed Hodgkin/ReedSternberg cells to be positive for IL-6 (bottom left) and VEGF (bottom right) antibodies. Following one course of combination chemotherapy, the clinical signs disappeared, the laboratory data normalized and the plasma levels of IL-6 and VEGF decreased to 5Æ0 pg/ml and 100 pg/ml respectively.