Concurrent immunoglobulin G-lambda type multiple myeloma and mixed cellularity classical Hodgkin lymphoma: A case...

Area of Science:

• Hematology
• Oncology
• Molecular Biology

Background:

• Multiple myeloma (MM) and Hodgkin lymphoma (HL) are distinct B-cell malignancies.
• Co-occurrence of MM and HL is exceptionally rare, posing diagnostic and therapeutic challenges.

Observation:

• A 66-year-old male presented with symptoms suggestive of MM, including bone disease and monoclonal protein.
• Pathological examination of lymph nodes revealed classical HL, contradicting the initial MM diagnosis.
• Despite treatment for both conditions, the patient experienced disease progression and ultimately succumbed to the illness.

Findings:

• Direct sequencing identified a shared immunoglobulin heavy chain (IgH) gene sequence in both bone marrow (MM) and lymph node (HL) samples.
• The clonotypic IgH sequence in HL cells suggests a common clonal origin with the MM plasma cells.
• These molecular findings indicate that the HL likely arose from the same B cell progenitor as the MM.

Implications:

• This case provides molecular evidence supporting the hypothesis of a shared clonal origin for concurrent MM and HL.
• Understanding the shared progenitor may lead to novel diagnostic markers and therapeutic strategies for rare dual hematologic malignancies.
• Further research into the molecular mechanisms underlying the development of co-existing B-cell neoplasms is warranted.