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Transformation of a splenic marginal zone lymphoma into classic Hodgkin lymphoma
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Transformation of a splenic marginal zone lymphoma into classic Hodgkin lymphoma
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Journal Article
Transformation of a splenic marginal zone lymphoma into classic Hodgkin lymphoma
2019
Overview
Correspondence to Professor Alexandar Tzankov, Institute of Pathology, University Hospital Basel, Basel 4031, Switzerland; alexandar.tzankov@usb.ch Sir, Transformation of marginal zone lymphoma (MZL) to aggressive lymphoma is considered a rare event with most cases evolving into diffuse large B-cell lymphoma (DLBCL).1 Here, we present a case of splenic MZL (sMZL) transforming into classic Hodgkin lymphoma (cHL). An imaging-guided bone biopsy revealed infiltrates of cHL (figure 1) while the patient still had residual histologically documented sMZL in the spleen and in the bone marrow in other locations at the time of cHL diagnosis. The positivity for IgD, alike the initial sMZL, along with the strong expression of CD30 and CD15, the dim expression of PAX5, and the negativity for BOB1 and CD45 in the Hodgkin- and Reed-Sternberg cells and the classical morphology strongly support our hypothesis of transformation, as genuine de novo cHL lack IgD expression6 and low-grade lymphomas with Reed-Sternberg-like cells lack the cellular background of cHL and are usually CD45 positive and CD15 negative.
Publisher
BMJ Publishing Group Ltd and Association of Clinical Pathologists,BMJ Publishing Group LTD
