title: Composite marginal zone B-cell lymphoma and classical Hodgkin's lymphoma: a clinicopathological study of 12 cases.
abstract: OBJECTIVE
  Classical Hodgkin's lymphoma (cHL) rarely coexists as composite lymphoma with B-cell non-Hodgkin's lymphoma (B-NHL). We characterized 12 cases of composite marginal zone B-cell lymphoma (MZBL) and cHL by immunohistochemistry and molecular biology.
  
  
  RESULTS
  Eight patients had gastric MZBL of mucosa-associated lymphoid tissue (MALT)-type, in five cases with a diffuse large B-cell lymphoma component. Concurrent cHL was observed either in the stomach wall, regional, or distant lymph nodes. One patient each had composite pulmonary/thyroid MZBL of MALT-type and cHL. In two cases, nodal composite MZBL and cHL was observed. cHL displayed features of mixed cellularity type in 10 cases, while in two cases only scattered Hodgkin- and Reed-Sternberg (H/RS) cells were noted. H/RS cells expressed CD30, multiple myeloma oncogene 1 protein (MUM1P), p53 (100%), CD15 (58%), CD20 (58%) and Epstein-Barr virus-associated LMP1 (50%). No t(11;18)(q21;q21) was detected in composite MZBL of MALT-type and cHL.
  
  
  CONCLUSIONS
  MZBL and cHL may occur as composite lymphoma, possibly reflecting clonal lymphoma progression. Derivation from extranodal MZBL of MALT-type should be excluded in cases in which a diagnosis of primary extranodal cHL is considered.
authors.affiliation: Institute of Pathology, University of Würzburg, Würzburg, Germany. andreas.zettl@mail.uni-wuerzburg.de
authors.forename: A
authors.initials: A
authors.lastname: Zettl
authors.forename: T
authors.initials: T
authors.lastname: Rüdiger
authors.forename: A
authors.initials: A
authors.lastname: Marx
authors.forename: H K
authors.initials: HK
authors.lastname: Müller-Hermelink
authors.forename: G
authors.initials: G
authors.lastname: Ott
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000032:analysis; D018951:Antigens, CD20 / Q000032:analysis; D001402:B-Lymphocytes / Q000378:metabolism / Q000473:pathology; D001980:Bronchi / Q000737:chemistry / Q000473:pathology; D051925:CD79 Antigens; D002880:Chromosomes, Human, Pair 11 / Q000235:genetics; D002887:Chromosomes, Human, Pair 18 / Q000235:genetics; D005260:Female; D006689:Hodgkin Disease / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D017730:Ki-1 Antigen / Q000032:analysis; D016256:Lewis X Antigen / Q000032:analysis; D008198:Lymph Nodes / Q000737:chemistry / Q000473:pathology; D016393:Lymphoma, B-Cell / Q000378:metabolism / Q000473:pathology*; D018442:Lymphoma, B-Cell, Marginal Zone / Q000378:metabolism / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis; D011947:Receptors, Antigen, B-Cell / Q000032:analysis; D013270:Stomach / Q000737:chemistry / Q000473:pathology; D013961:Thyroid Gland / Q000737:chemistry / Q000473:pathology; D014178:Translocation, Genetic; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
chemical_list: D015703:Antigens, CD; D018951:Antigens, CD20; D051925:CD79 Antigens; C497881:CD79A protein, human; D017730:Ki-1 Antigen; D016256:Lewis X Antigen; D019253:Proto-Oncogene Proteins c-bcl-2; D011947:Receptors, Antigen, B-Cell; D016159:Tumor Suppressor Protein p53