DISCORDANT MALIGNANT-LYMPHOMA SYNCHRONOUS OR SUCCESSIVE HIGH-GRADE B-LYMPHOMA ASSOCIATED WITH HODGKINS-DISEASE - A CLINICOPATHOLOGICAL AND IMMUNOPHENOTYPIC STUDY OF 4 CASES

We report in 4 patients the rare association of Hodgkin's disease and high grade B malignant lymphoma. In 2 cases, both tumours were disclosed at the same time but in different tissues from the same region. In the 2 other patients, the second tumour was found 11 months and 12 months after the first respectively. In all cases Hodgkin's disease was of the nodular sclerosing type, the tumour cells expressing CD 30 and CD 15. The high grade lymphomas were of the polymorphic centroblastic (large non cleaved) type and expressed the B markers. One (case 4) was secondary to a follicular lymphoma. In 2 cases (2 and 4) the search for a latent EBV infection was negative in both tumours. In case 1, only the Reed-Sternberg cells were positive with both techniques. Such an association is different from so-called composite lymphomas, and can be called ''discordant lymphoma''. Different related conditions are discussed. This association is distinct from lymphomas or Hodgkin's disease complicating the treatment of Hodgkin's disease or malignant lymphomas.