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Classical Hodgkin lymphoma arising in the rectum
Jose R Valbuena1, Gabriela Gualco, Ismael Espejo-Plascencia
1Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Annals of Diagnostic Pathology
|February 5, 2005
Summary
This case study details a rare rectal Hodgkin lymphoma in an immunocompetent patient. The lymphoma was confirmed via immunohistochemistry and linked to Epstein-Barr virus, a novel finding in such rectal cases.
Area of Science:
- Oncology
- Gastroenterology
- Pathology
Background:
- Rectal masses are often suspected to be carcinomas.
- Classical Hodgkin lymphoma (CHL) is a malignancy of lymphocytes.
- CHL rarely involves the rectum, especially in immunocompetent individuals.
Observation:
- An 81-year-old immunocompetent man presented with a rectal mass.
- Histopathology revealed nodular sclerosis type CHL involving the rectum.
- Immunohistochemistry confirmed neoplastic cells positive for CD15 and CD30, negative for CD45 (LCA).
Findings:
- Epstein-Barr virus (EBV) small-encoded RNA was detected in neoplastic cells via in situ hybridization.
- This represents the first reported case of EBV-positive rectal CHL in an immunocompetent patient.
- Only 12 cases of rectal CHL in immunocompetent patients have been documented, with immunohistochemical confirmation in two prior cases.
Implications:
- This case expands the understanding of CHL presentation and etiology.
- Highlights the importance of comprehensive diagnostic workup for rectal masses.
- Suggests a potential role for EBV in the pathogenesis of rectal CHL.