Composite nodular lymphocyte-predominance Hodgkin disease and gamma-heavy-chain disease - A case report and review of the literature

The association of Hodgkin disease with monoclonal gammopathy has rarely be en reported. We present a case of a 48-year-old woman with a history of aut oimmune hemolytic anemia and Graves disease who presented with hepatospleno megaly and a gamma -heavy-chain paraprotein. Histopathology of lymph node a nd bone marrow revealed nodular lymphocyte-predominance Hodgkin disease, wh ile examination of the spleen revealed plasmacytosis consistent with gamma -heavy-chain disease. Following splenectomy, the patient has remained in co mplete remission for both conditions with no further treatment. To our know ledge, this is the first report of a patient with both gamma -heavy-chain d isease and nodular lymphocyte-predominance Hodgkin disease. Given recent da ta indicating the B-cell nature of this form of Hodgkin disease, the author s propose that in this unique case there may be a clonal relationship betwe en these 2 concurrent B-cell lymphoproliferative processes.