Classical Hodgkin lymphoma concurrently evolving in a patient with marginal zone B-cell lymphoma of the spleen.

Academic Article

Abstract

  • Combination of the splenic marginal zone B-cell lymphoma (SMZL) and classical Hodgkin lymphoma (cHL) is extremely rare. We report a unique case with concurrent SMZL and cHL. The patient was a 63-year-old man who presented with fatigue and anemia, showing a splenomegaly and retroperitoneal lymphadenopathy. A splenectomy revealed monotonous marginal zone lymphocytic infiltrates and numerous large Reed-Sternberg-like cells. Flow cytometry revealed a kappa light-chain-restricted CD5 (-), CD23 (-) B-cell population. DNA polymerase chain reaction analysis confirmed the presence of clonal rearrangement of the immunoglobulin heavy-chain gene. Immunohistochemical studies revealed that the large atypical cells were CD30 (+), CD15 (weakly +), CD20 (-), CD45 (-), Pax5 (weakly +), BOB.1 (-), and Oct2 (-), indicating the coexistence of SMZL with cHL. After the chemotherapy, the patient achieved a clinical/radiologic remission, whereas cHL was detected in liver and bone marrow subsequently. The case indicates that both components of lymphoma can present concurrently as a composite form of lymphoma and both need to be treated adequately.

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    Keywords

  • Antigens, CD, B-Lymphocytes, Combined Modality Therapy, Gene Rearrangement, B-Lymphocyte, Heavy Chain, Hodgkin Disease, Humans, Lymphatic Diseases, Lymphoma, B-Cell, Marginal Zone, Male, Middle Aged, Neoplasms, Second Primary, Reed-Sternberg Cells, Remission Induction, Splenic Neoplasms, Splenomegaly

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    Author List

  • Harada S; Kalla H; Balasubramanian M; Brodsky I; Gladstone D; Hou JS

    • Start Page

  • 212

    • End Page

  • 216

    • Volume

  • 12

    • Issue

  • 3