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

Ann Diagn Pathol. 2008 Jun;12(3):212-6. doi: 10.1016/j.anndiagpath.2006.12.005. Epub 2007 Sep 14.

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.

Publication types

  • Case Reports

MeSH terms

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

Substances

  • Antigens, CD