title: Composite lymphoma of nodular lymphocyte-predominant and classical Hodgkin lymphoma-Epstein-Barr virus association suggests divergent pathogenesis despite clonal relatedness.
abstract: Nodular lymphocyte-predominant Hodgkin lymphoma and classical Hodgkin lymphoma are considered 2 distinct entities whose co-occurrence in 1 patient is extremely rare. We report a case of nodular lymphocyte-predominant Hodgkin lymphoma and classical Hodgkin lymphoma concurrently affecting the same lymph nodes in a 48-year-old male patient. Amplification and sequencing of the rearranged immunoglobulin heavy chain genes in tumor cells isolated by laser-assisted microdissection revealed identical variable, diverse and joining segment rearrangements and somatic hypermutation events, demonstrating a clonal relationship between the 2 lymphomas. The Epstein-Barr virus-encoded RNA and latent membrane protein 1 were present in the Hodgkin/Reed-Sternberg cells of the classical Hodgkin lymphoma but not in the tumor cells of the nodular lymphocyte-predominant Hodgkin lymphoma, pointing to a common precursor cell but differences in the early steps of pathogenesis.
authors: Department of Pathology, Hematopathology Section and Lymph Node Registry, University Hospital Schleswig-Holstein Campus Kiel/Christian Albrecht University, 24105 Kiel, Germany. m.szczepanowski@path.uni-kiel.de
authors: Monika
authors: M
authors: Szczepanowski
authors: Neus
authors: N
authors: Masqué-Soler
authors: Ilske
authors: I
authors: Oschlies
authors: Wolfgang
authors: W
authors: Schmidt
authors: Andreas
authors: A
authors: Lück
authors: Wolfram
authors: W
authors: Klapper
mesh_terms: D002999:Clone Cells; D058617:Composite Lymphoma / Q000276:immunology / Q000473:pathology* / Q000821:virology; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000276:immunology / Q000473:pathology*; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification*; D006689:Hodgkin Disease / Q000276:immunology / Q000473:pathology* / Q000821:virology; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D061346:Laser Capture Microdissection; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology; D008214:Lymphocytes / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000302:isolation & purification; D016539:Reed-Sternberg Cells / Q000276:immunology / Q000473:pathology / Q000821:virology; D014763:Viral Matrix Proteins
chemical_list: C037662:EBV-associated membrane antigen, Epstein-Barr virus; D007143:Immunoglobulin Heavy Chains; D012367:RNA, Viral; D014763:Viral Matrix Proteins