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Updated: Aug 6, 2026
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VDJ-Seq: Deep Sequencing Analysis of Rearranged Immunoglobulin Heavy Chain Gene to Reveal Clonal Evolution Patterns of B Cell Lymphoma
Published on: December 28, 2015
Composite recurrent hodgkin lymphoma and diffuse large B-cell lymphoma: one clone, two faces
Qin Huang1, Sharon P Wilczynski, Karen L Chang
1Division of Pathology, City of Hope National Medical Center, Duarte, CA 91010, USA.
American Journal of Clinical Pathology
|August 8, 2006
Summary
A rare composite lymphoma involving Hodgkin lymphoma and diffuse large B-cell lymphoma was found in a single small intestinal tumor. Both lymphoma types originated from the same clone, despite distinct features and Epstein-Barr virus status.
Area of Science:
- Oncology
- Hematopathology
- Gastrointestinal Oncology
Background:
- Composite lymphomas are rare neoplasms with distinct histological and immunophenotypic components.
- Understanding the clonal origin and evolution of composite lymphomas is crucial for diagnosis and treatment.
Observation:
- A 56-year-old male with a history of classical Hodgkin lymphoma presented with a perforated small intestinal tumor.
- The tumor exhibited two distinct components: one resembling Hodgkin lymphoma with CD30+/CD15+ cells and Epstein-Barr virus (EBV) positivity, and another consistent with diffuse large B-cell lymphoma (DLBCL) lacking CD30/CD15 and EBV.
Findings:
- Immunohistochemistry revealed distinct phenotypes for each component, with EBV in Hodgkin-like cells but not DLBCL cells.
- Molecular analysis, including immunoglobulin gene rearrangements and DNA sequencing, confirmed that both components arose from a single clonal origin.
- This indicates a striking divergence in morphology, immunophenotype, and EBV status within a clonally related tumor mass.
Implications:
- This case highlights the complex behavior of composite lymphomas and their potential for diverse presentations.
- It underscores the importance of comprehensive molecular analysis to establish clonal origin in composite neoplasms.
- Further research into the pathogenesis of composite lymphomas may reveal new therapeutic targets.
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