       Document 0359
 DOCN  M9460359
 TI    The interrelationship between Hodgkin's disease and non-Hodgkin's
       lymphomas.
 DT    9408
 AU    Jaffe ES; Zarate-Osorno A; Kingma DW; Raffeld M; Medeiros LJ;
       Hematopathology Section, National Cancer Institute, National; Institutes
       of Health, Bethesda, Maryland.
 SO    Ann Oncol. 1994;5 Suppl 1:S7-11. Unique Identifier : AIDSLINE
       MED/94226948
 AB    BACKGROUND: While Hodgkin's disease (HD) and the non-Hodgkin's lymphomas
       (NHLs) have long been regarded as distinct disease entities, recent
       observations suggest a closer association. The analysis of cases in
       which both diseases are present in the same anatomic site (composite
       lymphomas), or in separate sites (simultaneous or sequential HD and
       NHL), indicates that this phenomenon occurs more frequently than would
       be expected by chance alone. DESIGN: We reviewed our experience with
       composite, simultaneous, and sequential cases of HD and NHL, including
       both nodular lymphocyte-predominant HD (NLPHD) and the other (so-called
       'usual') subtypes of HD. Cases analyzed included 43 cases of NLPHD and
       large-cell lymphoma (LCL); 14 cases of NHL following HD; 12 cases of
       composite lymphoma; 2 cases of simultaneous HD and NHL involving
       different sites; 8 cases of chronic lymphocytic leukemia (CLL) with
       Reed-Sternberg (RS) cells; and 22 cases of HD following NHL.
       Immunophenotypic analysis of both components (HD & NHL) was performed
       when possible. In addition, in situ hybridization for Epstein-Barr virus
       (EBV) EBER1 mRNA was performed in 35 cases of usual HD associated with
       NHL. RESULTS: The most common form of composite lymphoma was coexistent
       NLPHD with LCL of B-cell immunophenotype. With the abnormal cells of
       NLPHD also being of B-cell lineage, this finding suggests the existence
       of a clonal relationship between the two components. The association of
       nodular sclerosis or mixed cellularity HD and NHL was less common but
       still significant. The vast majority of the NHL associated with HD were
       of B-cell origin, most commonly follicular lymphomas. EBV was identified
       more frequently in the NHL of composite NHL + HD (4/12 cases; 33%) than
       the other patient groups studied (2/23; 9%). Moreover, in 4/5 composite
       lymphomas both the HD and NHL component were EBV-positive, suggesting an
       origin from a common EBV-infected progenitor cell. CONCLUSION: These
       findings suggest that, at least in some cases, HD may be clonally
       related to an underlying B-cell malignancy, and that the Reed-Sternberg
       cell may be an altered B lymphocyte. A process that may have a different
       pathogenesis is the late occurrence of aggressive, usually EBV-negative
       (12/14 cases), B-cell NHL in patients successfully treated for HD. Such
       tumors may be related to an underlying and persistent immunodeficiency
       in these patients, and may be of similar pathogenesis to the
       Burkitt-like lymphomas associated with HIV-infection.
 DE    Diagnosis, Differential  Hodgkin's Disease/*PATHOLOGY  Human  Leukemia,
       Lymphocytic, Chronic/PATHOLOGY  Lymphoma, Large-Cell/PATHOLOGY
       Lymphoma, Non-Hodgkin's/*PATHOLOGY  Neoplasms, Multiple
       Primary/*PATHOLOGY  JOURNAL ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

