Composite splenic marginal zone lymphoma and classic Hodgkin lymphoma -- an unusual combination.

The simultaneous occurrence of Hodgkin lymphoma with a variety of B-cell Non-Hodgkin lymphomas (composite lymphoma) has been described. We report the first case of composite Hodgkin lymphoma and splenic marginal zone lymphoma occurring simultaneously in the same lymph node of a 64-year-old man who presented with cervical and axillary lymphadenopathy and massive splenomegaly. He had a peripheral blood lymphocytosis and a bone marrow infiltrated by small lymphocytes. However, cervical lymph node biopsy showed classic Hodgkin lymphoma. His splenomegaly showed only a partial response to six cycles of ABVD chemotherapy so he underwent splenectomy with biopsy of remaining nodes. Histology of the spleen and nodes showed splenic marginal zone lymphoma. Review of the original biopsy confirmed the presence of both diseases in the original lymph node.