DISCORDANT MALIGNANT-LYMPHOMA SYNCHRONOUS OR SUCCESSIVE HIGH-GRADE B-LYMPHOMA ASSOCIATED WITH HODGKINS-DISEASE - A CLINICOPATHOLOGICAL AND IMMUNOPHENOTYPIC STUDY OF 4 CASES

We report in 4 patients the rare association of Hodgkin's disease and high grade B malignant lymphoma. In 2 cases, both tumours were disclos ed at the same time but in different tissues from the same region. In the 2 other patients, the second tumour was found 11 months and 12 mon ths after the first respectively. In all cases Hodgkin's disease was o f the nodular sclerosing type, the tumour cells expressing CD 30 and C D 15. The high grade lymphomas were of the polymorphic centroblastic ( large non cleaved) type and expressed the B markers. One (case 4) was secondary to a follicular lymphoma. In 2 cases (2 and 4) the search fo r a latent EBV infection was negative in both tumours. In case 1, only the Reed-Sternberg cells were positive with both techniques. Such an association is different from so-called composite lymphomas, and can b e called ''discordant lymphoma''. Different related conditions are dis cussed. This association is distinct from lymphomas or Hodgkin's disea se complicating the treatment of Hodgkin's disease or malignant lympho mas.