Primary gastric Hodgkin's lymphoma

Abstract

Gastric Hodgkin's lymphoma is extremely rare. We present a case of primary Hodgkin's lymphoma arising in the stomach of a 65-year-old woman. The patient complained of epigastric discomfort and reflux for one month. Endoscopic examination revealed a protruding lesion characterized by a smooth surface at the antrum. An abdominal computed tomography uncovered a 2.5 × 2.0 cm, exophytic submucosal mass. After the tentative preoperative diagnosis of a gastrointestinal stromal tumor, a gastric wedge resection was performed. Microscopic examination of the mass demonstrated a diffuse proliferation of large atypical lymphoid cells with mono- and binucleated pleomorphic nuclei and prominent nucleoli. Immunohistochemically, the tumor cells were positive for CD30, CD20, and CD79a, whereas they were negative for cytokeratin, carcinoembryonic antigen, CD3, CD15, epithelial membrane antigen, and anaplastic lymphoma kinase-1. Based on the morphological features and immunohistochemical results, in addition to the clinical findings, a diagnosis of primary gastric Hodgkin's lymphoma was established.

Chronic Diarrhea: A rare presentation of Hodgkin’s Lymphoma

“…Classical cases of Hodgkin's lymphoma are Chronic Diarrhea in Hodgkin's Lymphoma positive for CD30 and CD15. Similar findings were seen in case by Kilaru et al 9 Our case was positive for CD 30 but negative for CD15, similar findings were seen in presented by Jung et al 8 Typical CHL may have CD-15 negative immunohistochemistry in about one-third of the cases. 10 Combination chemotherapy is used for treatment of Hodgkin's Lymphoma.…”

“…7 The overall prognosis of gastric Hodgkin's Lymphoma is very poor, and between 45 to 60% of the patient's dying within a year of diagnosis. 8 Here we report a rare presentation of Hodgkin's Lymphoma. The patient presented to our center and was diagnosed with Hodgkin's Lymphoma based on radiological and Biopsy findings consistent with the disease.…”

“… 7 The overall prognosis of gastric Hodgkin’s Lymphoma is very poor, and between 45 to 60% of the patient’s dying within a year of diagnosis. 8 …”

Hodgkin's lymphoma of the stomach: A rare entity

“…A close differential is anaplastic large cell lymphoma and is differentiated by the lack of T-cell markers and ALK negativity. [4] Prognosis of Hodgkin's lymphoma is difficult to ascertain due to rarity of cases and incomplete treatment and follow-up details. Our patient had incomplete response to chemotherapy, and we plan to proceed with partial gastrectomy and adrenal lesion biopsy in case of inadequate response with the second-line therapy.…”

“…Nil. [5] 1995 CD30 + , CD45 + CD15 − , EMA − Mori et al [6] 1995 CD30 + , CD3 − , CD15 not done Zippel et al [7] 1997 -Venizelos et al [8] 2005 CD30 + , CD15 + , EMA − CD20 + (weak), CD79a − Penázová et al [9] 2007 CD15 + , CD30 + Saito et al [10] 2007 CD30 + , CD20 + , CD79a + , CD3 − , CD15 − , EMA − , Oct-2 + , Bob-1 + Hossain et al [11] 2007 CD15 + , CD30 + , EBV-LMP1, CD20 + (weak), CD79a − , CD3 − , bcl-2 − , bcl-6 − Jung et al [4] 2012 CD30 + , CD20 + , CD79a + , CD3 − , CD15 − , EMA − , ALK1 − , c-kit − Current case -PAX5 + , CD30 + , MUM1 + , LCA − , CD15 − , ALK − , CD20 − , CD3 − , LMP1 − IHC: Immunohistochemistry…”