Composite B-cell and T-cell lymphoma arising 24 years after nodular lymphocyte predominant Hodgkin's disease

J. Christopher Hancock, Alan Wells, Kevin C. Halling, Ken Tilashalski, Michael G. Conner, Carol Johns, Catherine M. Listinsky

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Twenty-four years after apparently successful treatment for nodular lymphocyte predominant Hodgkin's disease (nLPHD), a 41-year old male developed "B" symptoms and extensive adenopathy. A right axillary lymph node biopsy showed two distinct regions including (1) histiocyte-rich B-cell lymphoma and (2) diffuse small T-cell lymphoma. A clonal rearrangement of the gene for the T-cell receptor beta chain confirmed the presence of a T-cell neoplasm, and this was further confirmed by selective polymerase chain reaction (PCR) on this morphologic zone. PCR on the morphologic B-cell lymphoma confirmed the presence of an immunoglobulin gene rearrangement. These two regions were separated by a less-defined zone containing a mixture of small CD57 positive T lymphocytes, small B lymphocytes, and rare lymphocytic and histiocytic (L&H) cells, highly suggestive of recurrent LPHD. The development of composite B-cell and T-cell lymphoma in this patient raises the speculation that nLPHD may be a neoplasm of lymphoid cells, which can differentiate in both B- and T-cell directions, with the "L&H" cells constituting their B-cell progeny.

Original languageEnglish (US)
Pages (from-to)23-34
Number of pages12
JournalAnnals of Diagnostic Pathology
Issue number1
StatePublished - 1999


  • B-cell lymphoma
  • Composite lymphoma
  • Gene rearrangement
  • Immunophenotype
  • L&H cell
  • LPHD
  • Lymphocyte predominant Hodgkin's disease
  • Non-Hodgkin's lymphoma
  • Reed-Sternberg cell
  • T-cell lymphoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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