Primary classic Hodgkin lymphoma of the ileum and Epstein-Barr virus mucocutaneous ulcer of the colon: two entities compared

Abstract

Primary classic Hodgkin lymphoma of the gastrointestinal tract represents a rare occurrence. A full patient's work-up is essential in order to exclude a secondary intestinal involvement. Histologically Epstein-Barr virus mucocutaneous ulcer closely resembles Hodgkin lymphoma. The differential diagnosis between these two entities is relevant, since both the therapeutic approach and the clinical behavior are different. Herein, we describe a case of primary classic Hodgkin lymphoma arising in the ileum and a case of Epstein-Barr virus mucocutaneous ulcer of the colon, focusing on the main clinicopathological differences.

EBV-Driven Lymphoproliferative Disorders and Lymphomas of the Gastrointestinal Tract: A Spectrum of Entities with a Common Denominator (Part 1)

“…EBVMCU involves extra-nodal sites, occurring in the oropharynx (52%), skin (29%) and GIT (19%) [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ].…”

“…The occurrence of EBVMCU in GIT is rather uncommon, with just about 30 cases reported so far [ 13 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ].…”

“…The most common setting is iatrogenic IS in inflammatory bowel disease (IBD) patients [ 13 , 18 , 19 , 20 , 28 ], followed by solid organ-transplanted patients [ 13 , 16 , 17 ], immune-related colitis (irColitis) [ 29 ], rheumatoid arthritis [ 13 ] and treated lymphoma [ 30 ]. Occasional cases are reported in patients with autoimmune thrombocytopenia, HIV, post-hematopoietic stem cell transplantation, hypogammaglobulinemia and rheumatic polymyalgia [ 21 , 22 , 37 ]. In a minority of GIT cases, EBVMCU develops in advanced age, without other known causes of IS [ 16 , 23 , 24 ].…”

“…Unlike EBVMCU, which is superficial, primary GI cHL is generally a tumor-forming lesion with transmural GI involvement [ 13 , 21 ]. Morphology and immunohistochemical profile of cHL are similar to EBVMCU.…”

“…The review consists of three parts. In this first part, EBVMCU [ 8 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ], EBV-positive diffuse large B-cell lymphoma not otherwise specified (EBV-positive DLBCL, NOS) [ 8 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ] and classic Hodgkin lymphoma (cHL) [ 8 ] are discussed.…”