Back to Search
Start Over
Discordant lymphoma consisting of mediastinal large B-cell lymphoma and nodular sclerosis Hodgkin lymphoma in the right supraclavicular lymph nodes: a case report.
- Source :
-
Diagnostic pathology [Diagn Pathol] 2015 Dec 29; Vol. 10, pp. 215. Date of Electronic Publication: 2015 Dec 29. - Publication Year :
- 2015
-
Abstract
- Background: Discordant lymphoma is defined by the simultaneous presence of two or more distinct types of lymphomas at different anatomic sites. With fewer than 20 studies reporting cases of discordant lymphoma to date, the incidence of this condition is believed to be very low.<br />Case Presentation: Here, we report a case of discordant lymphoma in a 34-year-old female patient that involved mediastinal large B-cell lymphoma and nodular sclerosis Hodgkin lymphoma in the right supraclavicular lymph nodes. The patient presented with a mass in the mediastinum and enlargement of the right supraclavicular lymph nodes, but no obvious signs of lymphoma. Histological examination revealed that the encapsulated mediastinal mass contained medium- or large-size tumor cells with lightly stained cytoplasm and round vesicular nuclei as well as a high percentage of mitotic cells; strongly positive immunohistochemical staining for PAX5, CD20, and CD79a also was observed. Examination of biopsied right supraclavicular lymph node tissues revealed separation by collagen fibers, extensive inflammatory cell infiltration, and large-size tumor cells, such as Reed-Sternberg cells. These tissues stained strongly positive for PAX5 and CD30, weakly positive for CD15, and negative for Epstein-Barr viral RNA. We also found monoclonal gene rearrangement in the immunoglobulin heavy chain gene in the mediastinal large B-cell lymphoma, but no monoclonal gene rearrangement in the nodular sclerosis Hodgkin lymphoma. These findings suggested that these two lymphomas were not of a common clonal origin. The patient was treated by surgical excision of the mediastinal mass followed by radio-chemotherapy, and no metastasis or recurrence occurred during a follow-up period of 32 months.<br />Conclusion: A review of previously reported cases indicated that the clinical manifestations and pathological features of discordant lymphoma are diverse due to variation in the types of lymphomas involved. Physicians must have an awareness of discordant lymphoma to avoid incorrect and missed diagnoses, especially considering that the true incidence may not be as low as previously believed.
- Subjects :
- Adult
Biomarkers, Tumor analysis
Biomarkers, Tumor genetics
Biopsy
Chemoradiotherapy, Adjuvant
Female
Gene Rearrangement
Genes, Immunoglobulin Heavy Chain
Hodgkin Disease genetics
Hodgkin Disease metabolism
Hodgkin Disease therapy
Humans
Immunohistochemistry
Lymph Node Excision
Lymph Nodes chemistry
Lymphoma, B-Cell chemistry
Lymphoma, B-Cell genetics
Lymphoma, B-Cell therapy
Mediastinal Neoplasms chemistry
Mediastinal Neoplasms genetics
Mediastinal Neoplasms therapy
Neoplasms, Complex and Mixed chemistry
Neoplasms, Complex and Mixed genetics
Neoplasms, Complex and Mixed therapy
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Hodgkin Disease pathology
Lymph Nodes pathology
Lymphoma, B-Cell pathology
Mediastinal Neoplasms pathology
Neoplasms, Complex and Mixed pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1746-1596
- Volume :
- 10
- Database :
- MEDLINE
- Journal :
- Diagnostic pathology
- Publication Type :
- Academic Journal
- Accession number :
- 26715530
- Full Text :
- https://doi.org/10.1186/s13000-015-0450-6