title: Composite nodular lymphocyte-predominance Hodgkin disease and gamma-heavy-chain disease: a case report and review of the literature.
abstract: The association of Hodgkin disease with monoclonal gammopathy has rarely been reported. We present a case of a 48-year-old woman with a history of autoimmune hemolytic anemia and Graves disease who presented with hepatosplenomegaly and a gamma-heavy-chain paraprotein. Histopathology of lymph node and bone marrow revealed nodular lymphocyte-predominance Hodgkin disease, while examination of the spleen revealed plasmacytosis consistent with gamma-heavy-chain disease. Following splenectomy, the patient has remained in complete remission for both conditions with no further treatment. To our knowledge, this is the first report of a patient with both gamma-heavy-chain disease and nodular lymphocyte-predominance Hodgkin disease. Given recent data indicating the B-cell nature of this form of Hodgkin disease, the authors propose that in this unique case there may be a clonal relationship between these 2 concurrent B-cell lymphoproliferative processes.
authors.affiliation: Department of Pathology and Laboratory Medicine, Division of (Hematopathology, University of Texas Medical Branch, Galveston, TX 77555-0741, USA. shudnall@utmb.edu
authors.forename: S D
authors.initials: SD
authors.lastname: Hudnall
authors.forename: J B
authors.initials: JB
authors.lastname: Alperin
authors.forename: J R
authors.initials: JR
authors.lastname: Petersen
mesh_terms: D001402:B-Lymphocytes / Q000276:immunology / Q000473:pathology; D005260:Female; D006362:Heavy Chain Disease / Q000150:complications* / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D006689:Hodgkin Disease / Q000150:complications* / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007142:Immunoglobulin gamma-Chains / Q000235:genetics / Q000378:metabolism; D007150:Immunohistochemistry; D008875:Middle Aged; D016133:Polymerase Chain Reaction
chemical_list: D007142:Immunoglobulin gamma-Chains