An unusual case of composite lymphoma involving chronic lymphocytic leukemia follicular lymphoma and Hodgkin disease.
Composite lymphomas constitute the presence of two different types of non-Hodgkin lymphoma or Hodgkin and non-Hodgkin lymphoma at the same anatomic site. We report an unusual case of a 73-year-old woman who initially presented with a composite lymphoma of chronic lymphocytic leukemia (CLL) and follicular lymphoma. After 5 years of follow-up and intermittent treatment, she developed Hodgkin disease with diffuse liver involvement. Biopsy of the liver showed Reed-Sternberg cells with typical morphology and immunophenotype. While fluorescent in situ hybridization (FISH) analyses for t(14;18) were positive in the lymph node tissue with follicular lymphoma, we were unable to show the same in the liver biopsy specimen. Here, we describe the clinical, morphologic, immunophenotypic, and cytogenetic features of this unusual composite lymphoma case involving CLL and follicular lymphoma, with the subsequent development of a Hodgkin lymphoma.
Copur
M Sitki
MS
Saint Francis Medical Center, Grand Island, Nebraska 68802-9804, USA mcopur@sfmc-gi.org
Ledakis
Peter
P
Novinski
Daniel
D
Fu
Kai
K
Hutchins
Mark
M
Frankforter
Scot
S
Mleczko
Kris
K
Sanger
Warren G
WG
Chan
Wing C
WC
D000368:Aged; D020732:Cytogenetic Analysis; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D008113:Liver Neoplasms / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D008223:Lymphoma / Q000145:classification* / Q000473:pathology; D008224:Lymphoma, Follicular / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D016609:Neoplasms, Second Primary; D012186:Retroperitoneal Neoplasms / Q000473:pathology