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Concurrent gastric MALT and Hodgkin lymphoma: a case report

Kuniyuki Oka1, Reizo Nagayama, Nobuo Yonekawa

  • 1Department of Pathology, Mito Saiseikai General Hospital, Mito, Ibaraki, Japan. oka-k@gb3.so-net.ne.jp

International Journal of Surgical Pathology
|August 5, 2011
PubMed

Insights

This case report details a rare instance of concurrent gastric extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) and classical Hodgkin lymphoma (CHL) in a single patient. The study explores potential origins, including MALT lymphoma transformation or de novo CHL development.

Area of Science:

  • Oncology
  • Gastroenterology
  • Hematopathology

Background:

  • Gastric extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is a B-cell neoplasm originating in the stomach.
  • Classical Hodgkin lymphoma (CHL) is a distinct lymphoid malignancy characterized by Hodgkin/Reed-Sternberg cells.
  • Concurrent presentation of these two distinct lymphomas is exceptionally rare.

Observation:

  • A 60-year-old male presented with concurrent gastric MALT lymphoma and CHL.
  • Histopathological examination revealed atypical lymphoid cells in the gastric mucosa forming lymphoepithelial lesions, admixed with Hodgkin/Reed-Sternberg cells.
  • Immunohistochemistry confirmed distinct cellular markers for MALT lymphoma (CD20+, CD79a+, PAX5+, BOB.1+) and CHL (CD30+, CD15+, EBV-encoded RNA+, EBV-LMP1+).

Findings:

  • The MALT lymphoma involved the gastric mucosa to the muscular layer.
  • Hodgkin/Reed-Sternberg cells were present within the MALT lymphoma background.
  • Only the CHL component showed invasion into regional lymph nodes.

Implications:

  • This case highlights the diagnostic challenges in differentiating concurrent lymphomas.
  • Two potential etiological pathways are considered: MALT lymphoma transformation into CHL or de novo CHL arising within a background of MALT lymphoma.
  • Further research is needed to elucidate the precise relationship and pathogenesis of these co-occurring gastric lymphomas.

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