Clinicopathological analysis of composite lymphoma: A two-case report and literature review

Abstract

ObjectiveThe objective of this study was to evaluate the clinicopathological features and treatment of composite lymphoma (CL) with cervical lymph node enlargement.MethodsIn this study, two cases of CL are presented. Biopsies of enlarged cervical lymph nodes by excision revealed two distinct types of lymphomas. The diagnoses were confirmed by routine histopathology, immunohistochemistry, in situ hybridization, polymerase chain reactions and flow cytometry. Case 1 was diagnosed with Hodgkin’s lymphoma and cytotoxic T-cell lymphoma complicated by Epstein–Barr virus infection. Case 2 was diagnosed with diffuse large B-cell lymphoma and angioimmunoblastic T-cell lymphoma.ResultsCase 1 received one cycle of adriamycin, bleomycin, vincristine and dacarbazine (ABVD regimen) combined with chidamide, followed by one cycle of gemcitabine and dexamethasone (GDP regimen) combined with chidamide, and then oral acyclovir. The patient achieved stable disease, but was lost to follow-up. Case 2 received eight cycles of cyclophosphamide, pirarubicin, vincristine and dexamethasone (CTOP regimen) combined with chidamide, and the patient achieved complete remission. Nine months later, relapse was confirmed. She received chidamide monotherapy for 3 months, which was then terminated. One year later, the patient underwent progressive disease and died.ConclusionsCL is a kind of rare disease. Due to the complexity of CL, clinicians should consider both disease components in order to increase the likelihood of effective treatment. This is important.

Plasticity in Classical Hodgkin Composite Lymphomas: A Systematic Review

“…A total of 11 cHL/T-cell composite lymphomas from seven articles were analyzed [ 60 , 109 , 110 , 111 , 112 , 113 , 114 ].…”

Classical Hodgkin Lymphoma progressing to Nodal T follicular helper cell lymphomas with aberrant CD20 expression and monoclonal TCR, IG rearrangements: A case report

“…The pathogenesis of CL may be related to immune defects, such as immunosuppression caused by EBV infection in patients or immune dysregulation due to autoimmune diseases like rheumatoid arthritis. Mutations in DNA methylation genes such as IDH2 may also contribute to CL [1,2]. In this case, the development of nTFHL-NOS following treatment for CHL may be attributed to several mechanisms.…”

“…Cases of CHL progressing to PTCL are particularly rare [1,2]. This study reports a case of a CHL patient who developed PTCL after receiving ABVD therapy, highlighting the clinical complexity of CHL with concurrent PTCL.…”

Primary Cutaneous B-Cell Lymphoma Co-Existing with Mycosis Fungoides—A Case Report and Overview of the Literature

“…Several mechanisms were proposed for explaining the occurrence of composite lymphomas with one being an immune deficiency secondary to an Epstein-Barr viral (EBV) infection [10]. There were several cases reported for which a EBV infection was documented, but there are also cases where the EBV infection was lacking, suggesting that other mechanisms can be involved in the development of CL [10][11][12][13]. For the case presented here, EBV infection was excluded by performing IgM and IgG serology for Epstein-Barr virus.…”