T-Cell-Rich B-Large-Cell Lymphoma Simulating Hodgkinʼs Disease: Report of Two Cases with Transformation to Pleomorphic B-Large-Cell Lymphoma

Malignant lymphomas resembling Hodgkinʼs disease in which the Hodgkinʼs-like cells express a B-cell phenotype pose a diagnostic and therapeutic dilemma. Recent studies have suggested these lymphomas are T-cell-rich B-large-cell lymphomas. In the present study we present two cases of malignant lymphomas meeting the histologic criteria for Hodgkinʼs disease, in which the Hodgkinʼs-like cells expressed a B-cell phenotype (CD20 positive, CD 15 negative, CD30 negative). In both cases therapy for Hodgkinʼs disease was unsuccessful, and the histology at relapse was that of a pleomorphic B-cell large-cell lymphoma. The findings support the view that malignant lymphomas resembling Hodgkinʼs disease, in which the Hodgkinʼs-like cells express a B-cell phenotype, are T-cell-rich B-large-cell lymphomas, and suggest a role for immunophenotyping of atypical cases of Hodgkinʼs disease.