Diffuse Large B Cell Lymphoma Relapsing as Classical Hodgkin Lymphoma: Report of Two Cases and Review of Literature

Abstract

Diffuse large B cell lymphoma (DLBCL) and classical Hodgkin lymphoma (CHL) can occur synchronously or sequentially. Here we reported two rare cases that patients relapsed as CHL after successful treatment for prior DLBCL. The first case was a 22-year-old male presented with chronic cough in April 2010. Imaging studies showed a 12-cm mediastinal mass. Biopsy of the mass revealed atypical lymphoid proliferation, consistent with DLBCL. The patient underwent autologous transplantation but developed reoccurrence of mediastinal mass in December 2012. Immunohistochemically, the recurrent tumor demonstrated CHL, nodular sclerosis (NSCHL) type. The second case was a 60-year-old female who was diagnosed with DLBCL in 2004. She received chemoradiation therapy and was in remission until April 2012 when bilateral cervical lymphadenopathy reoccurred. Histopathological examination established a diagnosis of NSCHL. Recent molecular studies demonstrated same immunoglobulin rearrangement pattern in composite DLBCL and NSCHL, it is likely that some DLBCL and NSCHL lymphomas can derive from common progenitor cells.