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Pathol Res Pract. 2016 Dec;212(12):1179-1190. doi: 10.1016/j.prp.2016.11.002. Epub 2016 Nov 5.

Composite lymphoma with diffuse large B-cell lymphoma and classical Hodgkin lymphoma components: A case report and review of the literature.

Author information

1
Department of Internal Medicine, Creighton University School of Medicine, 2500 California Plaza, Omaha, NE, USA.
2
Creighton University School of Medicine, 2500 California Plaza, Omaha, NE, USA.
3
Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, USA. Electronic address: gabriel.caponetti@uphs.upenn.edu.

Abstract

Composite lymphoma (CL) is an infrequently diagnosed entity in which two or more distinct types of lymphomas occur synchronously in the same organ or anatomical site. Most commonly, CLs are composed of two non-Hodgkin B-cell lymphomas. We present a case of a composite lymphoma with diffuse large B-cell lymphoma, not otherwise specified (DLBCL-NOS) and classical Hodgkin lymphoma (CHL) components involving the terminal ileum, colon and pericolic lymph nodes. Immunohistochemical evaluation for determination of cell of origin of the DLBCL-NOS component indicated a germinal center B-cell subtype. Immunoglobulin heavy chain fragment length analysis revealed identical dominant monoclonal peaks on the DH1-6-JH reaction, and also a dominant monoclonal peak observed only in the framework II reaction done on the CHL component, indicating a partial clonal relationship between the two components. Additionally, a review of the available literature reveals a total of 20 previously reported cases of CL with DLBCL-NOS and CHL components, and most of the tested cases showed clonal relationship between the two components. The overall findings indicate that in most cases, the two components of CL with DLBCL-NOS and CHL components are clonally related, and suggest a shared origin from a common B-cell precursor.

KEYWORDS:

Classical Hodgkin lymphoma; Composite lymphoma; Diffuse large B-cell lymphoma

PMID:
27887763
DOI:
10.1016/j.prp.2016.11.002
[Indexed for MEDLINE]

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