Clonally related splenic marginal zone lymphoma and Hodgkin lymphoma with unmutated V gene rearrangements and a 15-yr time gap between diagnoses.
Hodgkin lymphoma (HL) can rarely occur during the course of B-cell non-Hodgkin lymphoma (B-NHL), where both the HL and NHL tumours have been reported to be clonally related in most of the few combination lymphomas so far investigated. We here investigated a case that developed HL 15 yr after being diagnosed with an indolent B-cell lymphoma, classified as a splenic marginal zone lymphoma (SMZL). Analysis of rearranged immunoglobulin genes in the SMZL clone and in single Hodgkin Reed-Sternberg cells revealed presence of identical V gene rearrangements, thus demonstrating a clonal relationship. In contrast to previously described B-NHL/HL combinations, in this case both types of tumour cells carried unmutated V gene rearrangements. We conclude that the HL evolved from an unmutated tumour precursor, either the SMZL clone itself or a common earlier precursor.
Rosenquist
Richard
R
Department of Pathology, University of Frankfurt, Germany. richard.rosenquist@genpat.uu.se
Roos
Göran
G
Erlanson
Martin
M
Küppers
Ralf
R
Bräuninger
Andreas
A
Hansmann
Martin-Leo
ML
D002999:Clone Cells / Q000473:pathology; D005260:Female; D015321:Gene Rearrangement; D005803:Genes, Immunoglobulin / Q000235:genetics*; D006689:Hodgkin Disease / Q000209:etiology / Q000235:genetics / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D018442:Lymphoma, B-Cell, Marginal Zone / Q000235:genetics / Q000473:pathology*; D008875:Middle Aged; D013160:Splenic Neoplasms / Q000235:genetics / Q000473:pathology*; D013997:Time Factors