Composite lymphoma in the anterior mediastinum: a case report and review of the literature

Diagnostic Pathology - Tập 6 - Trang 1-7 - 2011
Guohua Yu1, Lingling Kong2, Guimei Qu1, Qian Zhang2, Wei Wang1, Lei Jiang1
1Department of Pathology, Affiliated Yantai Yuhuangding Hospital, Medical College of Qingdao University, Yantai, China
2Department of Pathology, Binzhou Medical University, Yantai, China

Tóm tắt

We recently encountered an unusual case of Composite lymphoma (CL) in the anterior mediastinum arising in a 37-year-old woman who presented initially with continuous pain in the right shoulder and chest. The woman had been suffered from continuous pain for three months before she went to our department of cardiovascular surgery. Chest computed tomography scan revealed the oval space-occupying lesion of anterior mediastinum. Surgery was performed and the disease was diagnosed pathologically as CL which composed of nodular sclerosing Hodgkin lymphoma and diffuse large B-cell lymphoma, via hematoxylin-eosin (H&E), immunohistochemical staining and in situ hybridization. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1975431863528091 .

Tài liệu tham khảo

National Cancer Institute sponsored study of classifications of non-Hodgkin's lymphomas: summary and description of a working formulation for clinical usage. The Non-Hodgkin's Lymphoma Pathologic Classification Project. Cancer. 1982, 49: 2112-2135. Kim H, Hendrickson R, Dorfman RF: Composite lymphoma. Cancer. 1977, 40: 959-976. 10.1002/1097-0142(197709)40:3<959::AID-CNCR2820400302>3.0.CO;2-3. Dargent JL, Lespagnard L, Meiers I, Bradstreet C, Heimann P, De Wolf-Peeters C: Composite follicular lymphoma and nodular lymphocyte predominance Hodgkin's disease. Virchows Arch. 2005, 447: 778-780. 10.1007/s00428-005-0008-1. Caleo A, Sánchez-Aguilera A, Rodríguez S, Dotor AM, Beltrán L, de Larrinoa AF, Menárguez FJ, Piris MA, García JF: Composite Hodgkin lymphoma and mantle cell lymphoma: two clonally unrelated tumors. Am J Surg Pathol. 2003, 27: 1577-1580. 10.1097/00000478-200312000-00012. Kaleem Z, McGuire MH, Caracioni AC, Leonard RL, Pathan MH, Lessmann EA, Chan WC: Composite B-cell and T-cell non-Hodgkin lymphoma of the tibia. Am J Clin Pathol. 2005, 123: 215-221. 10.1309/P6LUADHRL9TXFW2M. Kim H: Composite lymphoma and related disorders. Hematopathology. 1993, 99: 445-451. Custer RP: Pitfalls in the diagnosis of lymphoma and leukemia from pathologist's point of view. Proceedings of Second National Conference--New York American Cancer Society. 1954, 554-557. 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: 1376-1378. Hoppe RT: Histologic variation in non-Hodgkin's lymphomas: commentary. Cancer Treat Rep. 1981, 65: 11-12. Kim H, Dorfman RF: Morphological studies of 84 untreated patients subjected to laparotomy for the staging of non-Hodgkin's lymphoma. Cancer. 1974, 33: 657-674. 10.1002/1097-0142(197403)33:3<657::AID-CNCR2820330311>3.0.CO;2-D. Hell K, Hansmann ML, Pringle JH, Lauder I, Fischer R: Combination of Hodgkin's disease and diffuse large cell lymphoma: an in situ hybridization study for immunoglobulin light chain messenger RNA. Histopathology. 1995, 27: 491-499. 10.1111/j.1365-2559.1995.tb00319.x. Paulli M, Rosso R, Kindl S, Boveri E, Sirchi M, De Medici A, Invernizzi R, Magrini U: Nodular sclerosing Hodgkin's disease and large cell lymphoma. Immunophenotypic characterization of a composite case. Virchows Arch A Pathol Anat Histopathol. 1992, 421: 271-275. 10.1007/BF01611185. Huang Q, Wilczynski SP, Chang KL, Weiss LM: Composite recurrent Hodgkin lymphoma and diffuse large B-cell lymphoma. One clone, Two faces. Am J Clin Pathol. 2006, 126: 222-229. 10.1309/DDGLWRV3KR9164G7. Bellan C, Lazzi S, Zazzi M, Lalinga AV, Palummo N, Galieni P, Marafioti T, Tonini T, Cinti C, Leoncini L, Pileri SA, Tosi P: Immunoglobulin Gene Rearrangement Analysis in Composite Hodgkin Disease and Large B-Cell Lymphoma: Evidence for Receptor Revision of Immunoglobulin Heavy Chain Variable Region Genes in Hodgkin-Reed-Sternberg Cells?. Diagnostic Molecular Pathology. 2002, 11: 2-8. 10.1097/00019606-200203000-00002. Rosenquist R, Menestrina F, Lestani M, Küppers R, Hansmann ML, Bräuninger A: Indications for peripheral light-chain revision and somatic hypermutation without a functional B-cell receptor in precursors of a composite diffuse large B-cell and Hodgkin's lymphoma. Lab Invest. 2004, 84: 253-262. 10.1038/labinvest.3700025. Bräuninger A, Hansmann ML, Strickler JG, Dummer R, Burg G, Rajewsky K, Küppers R: Indentification of common germinal-center B-cell precursors in two patient with both Hodgkin's disease and non-Hodgkin's lymphoma. N Eng J Med. 1999, 340: 1239-1246. 10.1056/NEJM199904223401604. Savage KJ, Monti S, Kutok JL, Cattoretti G, Neuberg D, De Leval L, Kurtin P, Dal Cin P, Ladd C, Feuerhake F, Aguiar RC, Li S, Salles G, Berger F, Jing W, Pinkus GS, Habermann T, Dalla-Favera R, Harris NL, Aster JC, Golub TR, Shipp MA: The molecular signature of mediastinal large B-cell lymphoma differs from that of other diffuse large B-cell lymphomas and shares features with classical Hodgkin lymphoma. Blood. 2003, 102: 3871-3879. 10.1182/blood-2003-06-1841. Fend F, Quintanilla-Martinez L, Kumar S, Beaty MW, Blum L, Sorbara L, Jaffe ES, Raffeld M: Composite Low Grade B-Cell Lymphomas with Two Immunophenotypically Distinct Cell Populations Are True Biclonal Lymphomas A Molecular Analysis Using Laser Capture Microdissection. American Journal of Pathology. 1999, 154: 1857-1866. 10.1016/S0002-9440(10)65443-0. Greiner TC, Gascoyne RD, Anderson ME, Kingma DW, Adomat SA, Said J, Jaffe ES: Nodular lymphocyte-predominant Hodgkin's disease associated with large- cell lymphoma: analysis of Ig gene rearrangements by V-J polymerase chain reaction. Blood. 1996, 88: 657-666. Schmitz R, Renné C, Rosenquist R, Tinguely M, Distler V, Menestrina F, Lestani M, Stankovic T, Austen B, Bräuninger A, Hansmann ML, Küppers R: Insights into the multistep transformation process of lymphomas: IgH-associated translocations and tumor suppressor gene mutations in clonally related composite Hodgkin's and non-Hodgkin's lymphomas. Leukemia. 2005, 19: 1452-1458. 10.1038/sj.leu.2403841. Küppers R, Sousa AB, Baur AS, Strickler JG, Rajewsky K, Hansmann ML: Common germinal-center B-cell origin of the malignant cells in two composite lymphomas, involving classical Hodgkin's disease and either follicular lymphoma or B-CLL. Mol Med. 2001, 7: 285-292. Ohno T, Huang JZ, Wu G, Park KH, Weisenburger DD, Chan WC: The tumor cells in nodular lymphocyte-predominant Hodgkin disease are clonally related to the large cell lymphoma occurring in the same individual. Direct demonstration by single cell analysis. Am J Clin Pathol. 2001, 116: 506-511. 10.1309/KY8C-LCYN-QHJ6-4C6R. Kingma DW, Medeiros LJ, Barletta J, Raffeld M, Mann RB, Ambinder RF, Jaffe ES: Epstein-Barr virus is infrequently identified in non-Hodgkin's lymphomas associated with Hodgkin's disease. Am J Surg Pathol. 1994, 18: 48-61. 10.1097/00000478-199401000-00005. Jaffe ES, Harris NL, Stein H, et al.: World Health Organization classification of tumors. Pathology and genetics of tumors of hematopoietic and lymphoid tissues. 2001, IARC Press: Lyon, France Lamarre L, Jacobson JO, Aisenberg AC, Harris NL: Primary large cell lymphoma of the mediastinum. A histologic and immunophenotypic study of 29 cases. Am J Surg Pathol. 1989, 13: 730-739. 10.1097/00000478-198909000-00002. Rosenwald A, Wright G, Leroy K, Yu X, Gaulard P, Gascoyne RD, Chan WC, Zhao T, Haioun C, Greiner TC, Weisenburger DD, Lynch JC, Vose J, Armitage JO, Smeland EB, Kvaloy S, Holte H, Delabie J, Campo E, Montserrat E, Lopez-Guillermo A, Ott G, Muller-Hermelink HK, Connors JM, Braziel R, Grogan TM, Fisher RI, Miller TP, LeBlanc M, Chiorazzi M, Zhao H, Yang L, Powell J, Wilson WH, Jaffe ES, Simon R, Klausner RD, Staudt LM: Molecular diagnosis of primary mediastinal B cell lymphoma identifies a clinically favorable subgroup of diffuse large B cell lymphoma related to Hodgkin lymphoma. J Exp Med. 2003, 198: 851-862. 10.1084/jem.20031074. Faris JE, LaCasce AS: Primary mediastinal large B-cell lymphoma. Clin Adv Hematol Oncol. 2009, 7: 125-133. El Demellawy D, Ross C, Sur M, Alowami S: Synchronously diagnosed lymph nodal collision tumor of malignant melanoma and chronic lymphocytic leukemia/small lymphocytic lymphoma: case report. Diagn Pathol. 2007, 2: 34-10.1186/1746-1596-2-34. Travis LB, Gonzalez CL, Hankey BF, Jaffe ES: Hodgkin's disease following non-Hodgkin's lymphoma. Cancer. 1992, 69: 2337-2342. 10.1002/1097-0142(19920501)69:9<2337::AID-CNCR2820690923>3.0.CO;2-K.