Grey zone lymphoma with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma. Case report and literature review

Authors

  • Edgar Coronado-Alejandro Universidad de Monterrey
  • Emma Purón-González Universidad de Monterrey
  • Ricardo Ramírez-Morales Universidad de Monterrey
  • Fernando De La Garza-Salazar Universidad de Monterrey
  • Jorge Montemayor-Montoya Universidad de Monterrey

Keywords:

Grey Zone Lymphoma, Diffuse large B-cell lymphoma, Classical Hodgkin lymphoma, R-CHOP

Abstract

In the grey zone lymphomas (GZL), there are overlapping characteristics between diffuse large B-cell lymphoma (DLBCL) and classic Hodgkin lymphoma (CHL). The unusual nature of the pathology combined with the heterogeneity of the disease, its recent description as a specific entity, its diagnostic difficulty, and the lack of sufficient therapeutic experience justifies its continuous description.
The case is presented of a patient with a fever of one month onset, with no response to initial management. A left inguinal lymph node biopsy reported a diagnosis of GZL with intermediate characteristics between DLBCL and CHL. Although there are no established guidelines for the management of this condition, the current evidence suggests a better response in treatments meant for diffuse large B-cell lymphoma. This same therapy was used in this patient, with a favourable clinical outcome.

Author Biographies

Edgar Coronado-Alejandro , Universidad de Monterrey

Departamento de Medicina Interna, Christus Muguerza Alta Especialidad, Universidad de Monterrey,Monterrey, Nuevo León, México

Emma Purón-González, Universidad de Monterrey

Departamento de Medicina Interna, Christus Muguerza Alta Especialidad, Universidad de Monterrey, Monterrey, Nuevo León,
México

Ricardo Ramírez-Morales, Universidad de Monterrey

Departamento de Medicina Interna, Christus Muguerza Alta Especialidad, Universidad de Monterrey,Monterrey, Nuevo León, México

Fernando De La Garza-Salazar, Universidad de Monterrey

Departamento de Medicina Interna, Christus Muguerza Alta Especialidad, Universidad de Monterrey, Monterrey, Nuevo León, México

Jorge Montemayor-Montoya, Universidad de Monterrey

Departamento de Medicina Interna, Christus Muguerza Alta Especialidad, Universidad de Monterrey, Monterrey, Nuevo León, México

References

Pilichowska M, Pittaluga S, Ferry JA, Hemminger J, Chang H, Kanakry JA, et al. Clinicopathologic consensus study of gray zone lymphoma with features intermediate between DLBCL and classical HL. Blood Adv. 2017;1:2600-9.

https://doi.org/10.1182/bloodadvances.2017009472

Evens AM, Kanakry JA, Sehn LH, Kritharis A, Feldman T, Kroll A, et al. Gray zone lymphoma with features intermediate between classical Hodgkin lymphoma and diffuse large B-cell lymphoma: Characteristics, outcomes, and prognostication among a large multicenter cohort. Am J Hematol. 2015;90:778-83.

https://doi.org/10.1002/ajh.24082

Traverse-Glehen A, Pittaluga S, Gaulard P, Sorbara L, Alonso MA, Raffeld M, et al. Mediastinal gray zone lymphoma: the missing link between classic Hodgkin's lymphoma and mediastinal large B-cell lymphoma. Am J Surg Pathol. 2005;29:1411-21.

https://doi.org/10.1097/01.pas.0000180856.74572.73

Pilichowska M, Kritharis A, Evens AM. Gray Zone Lymphoma: Current Diagnosis and Treatment Options. Hematol Oncol Clin North Am. 2016;30:1251-60.

https://doi.org/10.1016/j.hoc.2016.07.006

Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al. World Health Organization. Classification of Tumours of Haematopoietic and Lymphoid Tissues. Fourth Edition Lyon, France: IARC; 2008.

Green MR, Monti S, Rodig SJ, Juszczynski P, Currie T, O'Donnell E, et al. Integrative analysis reveals selective 9p24.1 amplification, increased PD-1 ligand expression, and further induction via JAK2 in nodular sclerosing Hodgkin lymphoma and primary mediastinal large B-cell lymphoma. Blood. 2010;116: 3268-77.

https://doi.org/10.1182/blood-2010-05-282780

García J, Mollejo M, Fraga M, Forteza J, Muniesa J, Pérez- Guillermo M, et al. Large B-cell lymphoma with Hodgkin's features. Histopathology. 2005;47:101-10.

https://doi.org/10.1111/j.1365-2559.2005.02175.x

Quintanilla-Martínez L, de Jong D, de Mascarel A, Hsi ED, Kluin P, Natkunam Y, et al. Gray zones around diffuse large B cell lymphoma. Conclusions based on the workshop of the XIV meeting of the European Association for Hematopathology and the Society of Hematopathology in Bordeaux, France. J Hematop. 2009;2:211-36.

https://doi.org/10.1007/s12308-009-0053-9

Rüdiger T, Jaffe ES, Delsol G, de Wolf-Peeters C, Gascoyne RD, Georgii A, et al. Workshop report on Hodgkin's disease and related diseases ('grey zone' lymphoma). Ann oncol. 1998;9: S31-8.

https://doi.org/10.1093/annonc/9.suppl_5.S31

Norris D, Stone J. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (4th Edition) - Lymphoma Classification in the Third Millennium. QML Pathology Newsletter Issue 4. 2012:1-4.

Eberle FC, Salaverria I, Steidl C, Summers TA, Pittaluga S, Neriah SB, et al. Gray zone lymphoma: chromosomal aberrations with immunophenotypic and clinical correlations. Modern Pathology. 2011;24:1586-97.

https://doi.org/10.1038/modpathol.2011.116

Eberle FC, Rodriguez-Canales J, Wei L, Hanson JC, Killian JK, Sun HW, et al. Methylation profiling of mediastinal gray zone lymphoma reveals a distinctive signature with elements shared by classical Hodgkin's lymphoma and primary mediastinal large B-cell lymphoma. Haematologica. 2011;96:558-66.

https://doi.org/10.3324/haematol.2010.033167

Dunleavy K, Wilson WH. Primary mediastinal B-cell lymphoma and mediastinal gray zone lymphoma: do they require a unique therapeutic approach? Blood. 2015;125:33-9.

https://doi.org/10.1182/blood-2014-05-575092

Eberle FC, Jaffe ES XII. Gray zone lymphomas: a biological experiment, and a challenge for diagnosis and management. Annals of Oncology. 2011;22 suppl 4:iv64-6.

https://doi.org/10.1093/annonc/mdr178

Schwering I, Bräuninger A, Klein U, Jungnickel B, Tinguely M, Diehl V, et al. Loss of the B-lineage---specific gene expression program in Hodgkin and Reed-Sternberg cells of Hodgkin lymphoma. Blood. 2003;101:1505-12.

https://doi.org/10.1182/blood-2002-03-0839

Tanaka Y, Maeshima AM, Nomoto J, Makita S, Fukuhara S, Munakata W, et al. Expression pattern of PD-L1 and PD-L2 in classical Hodgkin lymphoma, primary mediastinal large B-cell lymphoma, and gray zone lymphoma. Eur J Haematol. 2018;100: 511-7.

https://doi.org/10.1111/ejh.13033

Wilson WH, Pittaluga S, Nicolae A, Camphausen K, Shovlin M, Steinberg SM, et al. A prospective study of mediastinal grayzone lymphoma. Blood. 2014;124:1563-9.

https://doi.org/10.1182/blood-2014-03-564906

Dunleavy K, Pittaluga S, Maeda LS, Advani R, Chen CC, Hessler J, et al. Dose-adjusted EPOCH-rituximab therapy in primary mediastinal B-cell lymphoma. N Engl J Med. 2013;368: 1408-16.

https://doi.org/10.1056/NEJMoa1214561

Ali Raufi, Abdul Shukkur Ebrahim, Ayad Al-Katib. Targeting CD19 in B-cell lymphoma: emerging role of SAR3419. Cancer Manag Res. 2013;5:225-33.

https://doi.org/10.2147/CMAR.S45957

Li J, Sim J, Leung AYH, Kwong YL. Favorable response of relapsed/ refractory gray-zone lymphoma to brentuximab vedotin. Ann Hematol. 2018;97:55-4.

https://doi.org/10.1007/s00277-017-3179-3

How to Cite

[1]
Coronado-Alejandro , E. et al. 2018. Grey zone lymphoma with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma. Case report and literature review. Revista Colombiana de Cancerología. 22, 4 (Dec. 2018), 146–150.

Downloads

Download data is not yet available.

Published

2018-12-01

Issue

Section

Reportes de caso