Classical Hodgkin lymphoma concurrently evolving in a patient with marginal zone B-cell lymphoma of the spleen

Shuko Harada, Hari Kalla, Manjula Balasubramanian, Isadore Brodsky, Douglas Gladstone, J. Steve Hou

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Combination of the splenic marginal zone B-cell lymphoma (SMZL) and classical Hodgkin lymphoma (cHL) is extremely rare. We report a unique case with concurrent SMZL and cHL. The patient was a 63-year-old man who presented with fatigue and anemia, showing a splenomegaly and retroperitoneal lymphadenopathy. A splenectomy revealed monotonous marginal zone lymphocytic infiltrates and numerous large Reed-Sternberg-like cells. Flow cytometry revealed a κ light-chain-restricted CD5 (-), CD23 (-) B-cell population. DNA polymerase chain reaction analysis confirmed the presence of clonal rearrangement of the immunoglobulin heavy-chain gene. Immunohistochemical studies revealed that the large atypical cells were CD30 (+), CD15 (weakly +), CD20 (-), CD45 (-), Pax5 (weakly +), BOB.1 (-), and Oct2 (-), indicating the coexistence of SMZL with cHL. After the chemotherapy, the patient achieved a clinical/radiologic remission, whereas cHL was detected in liver and bone marrow subsequently. The case indicates that both components of lymphoma can present concurrently as a composite form of lymphoma and both need to be treated adequately.

Original languageEnglish (US)
Pages (from-to)212-216
Number of pages5
JournalAnnals of Diagnostic Pathology
Issue number3
StatePublished - Jun 2008
Externally publishedYes


  • Composite lymphoma
  • Hodgkin lymphoma
  • Non-Hodgkin lymphoma
  • Reed-Sternberg cells
  • Spleen
  • Splenic marginal zone lymphoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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