Composite Hodgkin lymphoma and mantle cell lymphoma: two clonally unrelated tumors.
Association of Hodgkin lymphoma and non-Hodgkin lymphoma is rare and, specifically, the combination of Hodgkin lymphoma and mantle cell lymphoma has not been previously described. Here we describe composite mantle cell lymphoma and Hodgkin lymphoma affecting the spleen in one case and the eyelid and cervical lymph nodes in a second. In both, nodules of classical Hodgkin lymphoma were intermixed with diffuse or nodular areas of typical mantle cell lymphoma. Immunohistochemical and molecular analyses confirmed cyclin D1 overexpression secondary to the translocation t(11;14) in the small mantle cell lymphoma component; with CD30, CD15, and EBV expression in the Hodgkin and Reed-Sternberg cells. Finally, clonal analysis of rearranged immunoglobulin genes performed on microdissected Hodgkin and Reed-Sternberg and mantle cell lymphoma cells provided definite evidence of separate clonal origins of the two tumors in the patients. These EBV-positive, clonally unrelated tumors seem to represent true composite neoplasms, in contrast to cases showing merely clonal progression.
Caleo
Alessia
A
Department of Anatomic Pathology and Cytopathology, Faculty of Medicine and Surgery, Universita di Napoli Federico II, Naples, Italy.
Sánchez-Aguilera
Abel
A
Rodríguez
Sandra
S
Dotor
Ana M
AM
Beltrán
Luis
L
de Larrinoa
Aitor F
AF
Menárguez
Francisco J
FJ
Piris
Miguel A
MA
García
Juan F
JF
D000368:Aged; D000818:Animals; D020031:Epstein-Barr Virus Infections; D015326:Gene Rearrangement, B-Lymphocyte, Heavy Chain; D004854:Herpesvirus 4, Human; D006689:Hodgkin Disease / Q000209:etiology / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D017404:In Situ Hybridization, Fluorescence; D007834:Lasers; D020522:Lymphoma, Mantle-Cell / Q000209:etiology / Q000473:pathology*; D008297:Male; D042282:Microdissection; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000209:etiology / Q000473:pathology*; D016133:Polymerase Chain Reaction; D016539:Reed-Sternberg Cells / Q000502:physiology / Q000821:virology; D014178:Translocation, Genetic