Concurrent Hodgkin's disease (mixed cellularity type) and T-cell chronic lymphocytic leukemia/prolymphocytic leukemia

We describe a patient with leukopenic T-cell chronic lymphocytic leukemia/p rolymphocytic leukemia (T-CLL/PLL), according to the Revised European-Ameri can Classification of Lymphoid Neoplasms. This patient simultaneously devel oped classic Hodgkin's disease (HD), a combination previously unreported. T he leukemic cells were small and mature, did not have cytoplasmic granulati on, and appeared similar to B-cell chronic lymphocytic leukemia. Immunophen otyping of the bone marrow-infiltrating cells revealed a postthymic suppres sor/cytotoxic phenotype of CD2(+), CD3(+), CD4(-), CD5(+), CD8(+), CD25(-), TCR-ol P. A lymph node biopsy showed the histological features of HD (mixe d cellularity) with infiltrating CD8(+) lymphocytes, and immunohistochemica l examination revealed the following phenotype of Reed-Sternberg cells: Leu M1/CD15(+), BerH2/CD30(+), L26/PanB(-), UCHL-1/CD45RO(-), cyCD3(-), CD4-, C D8(-), CD20(-), CD79a(-), EMA(-), EBER-1(+), LMP-1(+). Southern blot analys is of the bone marrow and lymph node revealed the same rearrangement of ban ds of T-cell-receptor genes. Although the HD was treated with chemotherapy that resulted in complete remission, the T-PLL/CLL took an indolent course. This case may suggest the existence of a subtype of T-CLL/PLL with leukope nia and an indolent clinical course. Both diseases were believed to be inde pendent and not a transformation of one to the other. (C) 2001 The Japanese Society of Hematology.