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  • Title: Composite lymphoma of nodular lymphocyte-predominant and classical Hodgkin lymphoma-Epstein-Barr virus association suggests divergent pathogenesis despite clonal relatedness.
    Author: Szczepanowski M, Masqué-Soler N, Oschlies I, Schmidt W, Lück A, Klapper W.
    Journal: Hum Pathol; 2013 Jul; 44(7):1434-9. PubMed ID: 23427872.
    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.
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