Lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia associated with Hodgkin disease - A report of two cases

Although the clinical course of lymphoplasmacytic lymphoma (LPL)/Waldenstro m macroglobulinemia (WM) is usually indolent, high-grade non-Hodgkin lympho ma may develop in a small subset of patients. We have not found any patient s with LPL/WM associated with Hodgkin disease (HD) described in the literat ure, prompting us to report 2 cases. In case 1, the patient had LPL/WM invo lving bone marrow; diagnosed 1 week before left supraclavicular lymph node biopsy revealed LPL/WM and classical HD. In case 2, the patient had a 15-ye ar history of LPL/WM before classical HD developed involving bone marrow, l iver; and lymph node. Both cases were positive for IgM, monotypic immunoglo bulin light chain, and B-cell antigens and were CD3-, The neoplastic Hodgki n cells were CD15+, CD20+ (case 1), CD30+, CD3-, and CD45- and were negativ e for Epstein-Barr virus RNA. Both patients were treated with chemotherapy for HD. in case 1, clinical response was excellent with no histologic evide nce of HD in subsequent biopsy specimens. In case 2, HD was progressive at Inst follow-tip, despite therapy. Patients with LPL/WM; similar to patients with other types of low-grade B-cell lymphoma, can develop HD that may res pond to chemotherapy.