title: B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma without mediastinal disease: mimicking nodular sclerosis classical Hodgkin lymphoma.
abstract: B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma (BCLu-DLBCL/CHL), also known as gray-zone lymphoma, has overlapping clinical and biological characteristics of both diffuse large B-cell lymphoma and classical Hodgkin lymphoma (CHL). These lymphomas are typically associated with mediastinal disease, and extranodal involvement is rare. In the present report, we describe a case of a 78-year-old woman with BCLu-DLBCL/CHL found to have extranodal lesions and no evidence of mediastinal disease. Although biopsy specimens were histologically similar to nodular sclerosis CHL, the tumor cells were positive for CD30 and mature B-cell markers, such as CD20, CD79a, PAX5, BOB.1, and OCT-2, but negative for CD15. Furthermore, the patient had extranodal lesions and an increased level of soluble IL-2 receptor. These findings are unusual in CHL. Therefore, we diagnosed the patient with BCLu-DLBCL/CHL. She received adriamycin, bleomycin, vincristine, and dacarbazine therapy and exhibited partial response. Some cases without mediastinal disease, such as our case, have been reported; however, these cases are rare and further studies are required.
authors.affiliation: Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Iwaki
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Sato
authors.forename: Toshiro
authors.initials: T
authors.lastname: Kurokawa
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Maeda
authors.forename: Kyotaro
authors.initials: K
authors.lastname: Ohno
authors.forename: Mai
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Takata
authors.forename: Yorihisa
authors.initials: Y
authors.lastname: Orita
authors.forename: Shinji
authors.initials: S
authors.lastname: Nakao
authors.forename: Tadashi
authors.initials: T
authors.lastname: Yoshino
mesh_terms: D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging* / Q000473:pathology; D008477:Mediastinal Diseases / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging