Composite marginal zone B-cell lymphoma and classical Hodgkin's lymphoma: a clinicopathological study of 12 cases
A Zettl
Institute of Pathology, University of Würzburg, Würzburg, Germany
Search for more papers by this authorT Rüdiger
Institute of Pathology, University of Würzburg, Würzburg, Germany
Search for more papers by this authorA Marx
Institute of Pathology, University of Würzburg, Würzburg, Germany
Search for more papers by this authorH K Müller-Hermelink
Institute of Pathology, University of Würzburg, Würzburg, Germany
Search for more papers by this authorG Ott
Institute of Pathology, University of Würzburg, Würzburg, Germany
Search for more papers by this authorA Zettl
Institute of Pathology, University of Würzburg, Würzburg, Germany
Search for more papers by this authorT Rüdiger
Institute of Pathology, University of Würzburg, Würzburg, Germany
Search for more papers by this authorA Marx
Institute of Pathology, University of Würzburg, Würzburg, Germany
Search for more papers by this authorH K Müller-Hermelink
Institute of Pathology, University of Würzburg, Würzburg, Germany
Search for more papers by this authorG Ott
Institute of Pathology, University of Würzburg, Würzburg, Germany
Search for more papers by this authorAbstract
Aims : Classical Hodgkin's lymphoma (cHL) rarely coexists as composite lymphoma with B-cell non-Hodgkin's lymphoma (B-NHL). We characterized 12 cases of composite marginal zone B-cell lymphoma (MZBL) and cHL by immunohistochemistry and molecular biology.
Methods and results : Eight patients had gastric MZBL of mucosa-associated lymphoid tissue (MALT)-type, in five cases with a diffuse large B-cell lymphoma component. Concurrent cHL was observed either in the stomach wall, regional, or distant lymph nodes. One patient each had composite pulmonary/thyroid MZBL of MALT-type and cHL. In two cases, nodal composite MZBL and cHL was observed. cHL displayed features of mixed cellularity type in 10 cases, while in two cases only scattered Hodgkin- and Reed–Sternberg (H/RS) cells were noted. H/RS cells expressed CD30, multiple myeloma oncogene 1 protein (MUM1P), p53 (100%), CD15 (58%), CD20 (58%) and Epstein–Barr virus-associated LMP1 (50%). No t(11;18)(q21;q21) was detected in composite MZBL of MALT-type and cHL.
Conclusions : MZBL and cHL may occur as composite lymphoma, possibly reflecting clonal lymphoma progression. Derivation from extranodal MZBL of MALT-type should be excluded in cases in which a diagnosis of primary extranodal cHL is considered.
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