Elastic variant of mantle cell lymphoma following interfollicular Hodgkin's lymphoma

Infrequently, patients are diagnosed with Hodgkin's lymphoma and a morpholo gically distinct lymphoma. While specific subtypes of lymphomas (including Hodgkin's lymphoma) may present diagnostic difficulties, fine needle aspira tion biopsy (FNAB) is sometimes useful in the evaluation and classification of these lymphoproliferative processes. We report a case of the blastic va riant of mantle cell lymphoma following Hodgkin's lymphoma, interfollicular variant. A 66-year-old woman with a history of Hodgkin's lymphoma presente d with increasing contralateral cervical adenopathy three years after recei ving chemotherapy. FNAB with ancillary immunophenotypic characterization id entified mantle cell lymphoma, blastic variant. Subsequent excisional biops y confirmed this diagnosis and also aided in the exclusion of recurrent Hod gkin's lymphoma. In addition to identifying the previously unreported combi nation of blastic variant of mantle cell lymphoma and Hodgkin's lymphoma, t his case emphasizes the utility of FNAB in evaluation of new masses in pati ent's with a previous diagnosis of Hodgkin's lymphoma.