Concurrent Hodgkin's disease (mixed cellularity type) and T-cell chronic lymphocytic leukemia/prolymphocytic leukemia

Int J Hematol. 2001 Feb;73(2):230-5. doi: 10.1007/BF02981943.

Abstract

We describe a patient with leukopenic T-cell chronic lymphocytic leukemia/prolymphocytic leukemia (T-CLL/PLL), according to the Revised European-American Classification of Lymphoid Neoplasms. This patient simultaneously developed classic Hodgkin's disease (HD), a combination previously unreported. The leukemic cells were small and mature, did not have cytoplasmic granulation, and appeared similar to B-cell chronic lymphocytic leukemia. Immunophenotyping of the bone marrow-infiltrating cells revealed a postthymic suppressor/cytotoxic phenotype of CD2+, CD3+, CD4, CD5+, CD8+, CD25-, TCR-alpha beta. A lymph node biopsy showed the histological features of HD (mixed cellularity) with infiltrating CD8+ lymphocytes, and immunohistochemical examination revealed the following phenotype of Reed-Sternberg cells: LeuM1/CD15+, BerH2/CD30+, L26/PanB-, UCHL-1/CD45RO-, cyCD3-, CD4, CD8-, CD20-, CD79a-, EMA-, EBER-1+, LMP-1+. Southern blot analysis of the bone marrow and lymph node revealed the same rearrangement of bands of T-cell-receptor genes. Although the HD was treated with chemotherapy that resulted in complete remission, the T-PLL/CLL took an indolent course. This case may suggest the existence of a subtype of T-CLL/PLL with leukopenia and an indolent clinical course. Both diseases were believed to be independent and not a transformation of one to the other.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antigens, CD / analysis
  • Bone Marrow / chemistry
  • Bone Marrow / pathology
  • Gene Rearrangement
  • Hodgkin Disease / complications*
  • Hodgkin Disease / pathology
  • Humans
  • Immunohistochemistry
  • Immunophenotyping
  • Leukemia, Prolymphocytic / complications
  • Leukemia, Prolymphocytic, T-Cell / complications*
  • Leukemia, Prolymphocytic, T-Cell / pathology
  • Leukemic Infiltration / pathology
  • Lymph Nodes / chemistry
  • Lymph Nodes / pathology
  • Male
  • Receptors, Antigen, T-Cell / genetics
  • Reed-Sternberg Cells / chemistry
  • Reed-Sternberg Cells / pathology

Substances

  • Antigens, CD
  • Receptors, Antigen, T-Cell