Generic placeholder image

Cardiovascular & Hematological Disorders-Drug Targets


ISSN (Print): 1871-529X
ISSN (Online): 2212-4063

Case Report

Coexistence of Hodgkin and Non-Hodgkin Lymphoma; Composite Lymphoma [CL] in a Patient Presenting with Waxing and Waning Lymphadenopathy

Author(s): Eleni Geladari, Georgia Dimopoulou, Evangelia Margellou, Andreas Paraskevas, Georgios Kafetzis, Dimitra Rontogianni and Maria Vadiaka*

Volume 20, Issue 2, 2020

Page: [160 - 163] Pages: 4

DOI: 10.2174/1871529X19666191014111118

Price: $65


Background: The coexistence of two or more types of lymphoma within the same organ at the same time of diagnosis is defined as composite lymphoma, a rare disease that has recently been identified in the literature. Pointedly, the concurrence may be Hodgkin lymphoma with a Non-Hodgkin lymphoma [NHL], either B or T cells, or two different entities of NHLs. Furthermore, this condition has been described concurrently or sequentially. In order for the diagnosis to be established, two or more distinct clones should be proven by morphological and laboratory tests.

Case Presentation: Herein, we cite a seventy-three-year old female patient with low-grade fever, waxing and waning cervical lymphadenopathy, whose biopsy of an axillary lymph node demonstrated the rare coexistence of Hodgkin and NHL, known as composite lymphoma.

Conclusion: Composite lymphomas pose a particular diagnostic challenge, and currently, there are no agreed standards for treatment.

Keywords: Waxing and waning lymphadenopathy, composite lymphoma, Hodgkin lymphoma, Non-Hodgkin lymphoma, malignancies, castleman disease.

Graphical Abstract
Sanchez, S.; Holmes, H.; Katabi, N.; Newman, J.; Domiatti-Saad, R.; Stone, M.; Netto, G. Composite lymphocyte-rich Hodgkin lymphoma and peripheral T-cell lymphoma associated with Epstein-Barr virus: a case report and review of the literature. Arch. Pathol. Lab. Med., 2006, 130(1), 107-112.
[PMID: 16390224]
Küppers, R.; Dührsen, U.; Hansmann, M.L. Pathogenesis, diagnosis, and treatment of composite lymphomas. Lancet Oncol., 2014, 15(10), e435-e446.
[] [PMID: 25186047]
Mokhtar, N.M. Review article composite lymphoma. J. Egypt. Natl. Canc. Inst., 2007, 19(3), 171-175.
[PMID: 19190689]
Nassabein, R.; Fleifel, S.; Bejjani, N.; Ghanem, H.; Gerges, D.A. Composite hodgkin and non-hodgkin lymphomas: Report of two cases with unusual presentations. J. Blood Lymph, 2017, 7, 180.
Swerdlow, S.H.; Campo, E.; Harris, N.L. Classifi cation of tumours of haematopoietic and lymphoid tissues, 4th ed; IARC Press: Lyon, 2008.
Thirumala, S.; Esposito, M.; Fuchs, A. An unusual variant of composite lymphoma: a short case report and review of the literature. Arch. Pathol. Lab. Med., 2000, 124(9), 1376-1378.
[PMID: 10975943]
Jaffe, E.S.; Zarate-Osorno, A.; Kingma, D.W.; Raffeld, M.; Medeiros, L.J. The interrelationship between Hodgkin’s disease and non-Hodgkin’s lymphomas. Ann. Oncol., 1994, 5(1), 7-11.
[] [PMID: 8172822]
Campidelli, C.; Sabattini, E.; Piccioli, M.; Rossi, M.; De Blasi, D.; Miraglia, E.; Rodriguez-Abreu, D.; Franscini, L.L.; Bertoni, F.; Mazzucchelli, L.; Cavalli, F.; Zucca, E.; Pileri, S.A. Simultaneous occurrence of peripheral T-cell lymphoma unspecified and B-cell small lymphocytic lymphoma. Report of 2 cases. Hum. Pathol., 2007, 38(5), 787-792.
[] [PMID: 17270243]
Wang, H.Y.; Karandikar, N.; Payne, D.; Maleki, A.; Schultz, B.A.; Collins, R.; McKenna, R.W. A 3-way collision tumor of the upper respiratory tract: a composite of 2 immunophenotypically distinct mantle cell lymphomas and a plasmacytoma. Hum. Pathol., 2008, 39(5), 781-787.
[] [PMID: 18284935]
Yun, W.K.; Ko, Y.H.; Kim, D.S.; Kim, W.S.; Rhee, P.L.; Kwak, S.Y.; Jang, T.H.; Choi, W.S. Composite marginal zone B cell lymphoma and enteropathy-type T cell lymphoma of the stomach: a case report. Eur. J. Gastroenterol. Hepatol., 2008, 20(8), 791-795.
[] [PMID: 18617785]
Falchi, L.; Capello, D.; Palumbo, B.; Rauco, A.; Emili, R.; Cianciulli, M.; Pace, R.; Capparella, V.; Liberati, F.; Liberati, A.M. A case of nodular sclerosis Hodgkin’s lymphoma repeatedly relapsing in the context of composite plasma cell-hyaline vascular Castleman’s disease: successful response to rituximab and radiotherapy. Eur. J. Haematol., 2007, 79(5), 455-461.
[] [PMID: 17908180]
Hirose, Y.; Fukushima, T.; Masaki, Y.; Shimoyama, K.; Karasawa, H.; Ogawa, N.; Wano, Y. Epstein-Barr virus-associated composite lymphoma composed of peripheral T-cell lymphoma and an anaplastic variant of a diffuse large B-cell type of non-Hodgkin’s lymphoma and strongly expressing p53 protein. Int. J. Hematol., 2004, 79(3), 260-265.
[] [PMID: 15168595]
van den Berg, A.; Maggio, E.; Rust, R.; Kooistra, K.; Diepstra, A.; Poppema, S. Clonal relation in a case of CLL, ALCL, and Hodgkin composite lymphoma. Blood, 2002, 100(4), 1425-1429.
[PMID: 12149227]
Custer, R. Pitfalls in the diagnosis of lymphoma and leukemia from the pathologist’s point of view. Second National Cancer Conference, New York1954, pp. 554-7.
Kim, H.; Hendrickson, R.; Dorfman, R.F. Composite lymphoma. Cancer, 1977, 40(3), 959-976.
[<959:AID-CNCR2820400302>3.0.CO;2-3] [PMID: 332325]
Kim, H.; Dorfman, R.F. Morphological studies of 84 untreated patients subjected to laparotomy for the staging of non-Hodgkin’s lymphomas. Cancer, 1974, 33(3), 657-674.
[<657:AID-CNCR2820330311>3.0.CO;2-D] [PMID: 4592903]
Traverse-Glehen, A.; Pittaluga, S.; Gaulard, P.; Sorbara, L.; Alonso, M.A.; Raffeld, M.; Jaffe, E.S. Mediastinal gray zone lymphoma: the missing link between classic Hodgkin’s lymphoma and mediastinal large B-cell lymphoma. Am. J. Surg. Pathol., 2005, 29(11), 1411-1421.
[] [PMID: 16224207]
Montoto, S.; Fitzgibbon, J. Transformation of indolent B-cell lymphomas. J. Clin. Oncol., 2011, 29(14), 1827-1834.
[] [PMID: 21483014]
Hoeller, S.; Copie-Bergman, C. Grey zone lymphomas: lymphomas with intermediate features. Adv. Hematol., 2012, 2012460801
[] [PMID: 22548066]
Harada, S.; Kalla, H.; Balasubramanian, M.; Brodsky, I.; Gladstone, D.; Hou, J.S. Classical Hodgkin lymphoma concurrently evolving in a patient with marginal zone B-cell lymphoma of the spleen. Ann. Diagn. Pathol., 2008, 12(3), 212-216.
[] [PMID: 18486899]
Lefebvre, C.; Fabre, B.; Vettier, C.; Rabin, L.; Florin, A.; Wang, J.; Gressin, R.; Jacob, M.C.; Callanan, M.; Leroux, D. Composite splenic marginal zone lymphoma and mantle cell lymphoma arising from 2 independent B-cell clones. Hum. Pathol., 2007, 38(4), 660-667.
[] [PMID: 17134739]
Elmahy, H.; Hawley, I.; Beard, J. Composite splenic marginal zone lymphoma and classic Hodgkin lymphoma -- an unusual combination. Int. J. Lab. Hematol., 2007, 29(6), 461-463.
[] [PMID: 17988302]
Dunleavy, K.; Pittaluga, S.; Maeda, L.S.; Advani, R.; Chen, C.C.; Hessler, J.; Steinberg, S.M.; Grant, C.; Wright, G.; Varma, G.; Staudt, L.M.; Jaffe, E.S.; Wilson, W.H. Dose-adjusted EPOCH-rituximab therapy in primary mediastinal B-cell lymphoma. N. Engl. J. Med., 2013, 368(15), 1408-1416.
[] [PMID: 23574119]
Khan, U.; Hadid, T.; Ibrar, W.; Sano, D.; Al-Katib, A. Composite Lymphoma: Opposite Ends of Spectrum Meet. J. Clin. Med. Res., 2017, 9(3), 213-215.
[] [PMID: 28179969]

Rights & Permissions Print Export Cite as
© 2022 Bentham Science Publishers | Privacy Policy