title: Rectal Hodgkin lymphoma in a patient with ulcerative colitis: a case study.
abstract: A case of Hodgkin lymphoma located in the rectum of a patient with ulcerative colitis is described. The patient was a 44 year old male treated with thiopurines for ulcerative colitis for ten years. He was admitted with malaise, weight loss and abdominal pain. Endoscopy revealed a large ulcerative lesion involving the rectum and distal part of the sigmoid colon. Although it macroscopically resembled a rectal cancer, repeated biopsies did not reveal any malignancy. In order to resolve the symptoms of stenosis and to get the final diagnosis a recto-sigmoid resection was performed. Pathologic examination revealed nodular sclerosis classical Hodgkin lymphoma, positive for Epstein Barr Virus. Subsequent examination revealed disseminated disease involving the pelvic wall, liver, and bone marrow. The patient is currently receiving chemotherapeutic treatment, and follow-up shows disease remission.Hodgkin lymphoma associated with immunosuppressive therapy is rare. However, patients with ulcerative colitis receiving such treatment are at increased risk of lymphoproliferative disordes, potentially due to loss of immunosurveillance and presence of oncogenic viruses (i.e. Epstein-Barr virus). Virtual Slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/6156776351558952.
authors.affiliation: Department of Gastrointestinal Surgery, Clinical Cancer Research Center, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark. simon.rasmussen@rn.dk.
authors.forename: Simon Ladefoged
authors.initials: SL
authors.lastname: Rasmussen
authors.affiliation: Institute of Pathology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark. christian.t@rn.dk.
authors.forename: Christian
authors.initials: C
authors.lastname: Thomsen
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D017024:Chemotherapy, Adjuvant; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D003113:Colonoscopy; D004854:Herpesvirus 4, Human / Q000235:genetics; D006689:Hodgkin Disease / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy / Q000821:virology; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D017403:In Situ Hybridization; D008297:Male; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000235:genetics; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy / Q000821:virology; D012074:Remission Induction; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D012367:RNA, Viral