George Washington University Hospital, Washington, DC.
Ann Diagn Pathol. 2010 Aug;14(4):268-72. doi: 10.1016/j.anndiagpath.2009.09.006. Epub 2009 Dec 1.
The diagnoses of Hodgkin lymphoma and multiple myeloma have rarely been made simultaneously in the same patient. We present a case of an 82-year-old man who rapidly developed pancytopenia and liver failure with coagulopathy. Serum protein electrophoresis and immunofixation revealed an unequivocal immunoglobulin Gkappa and immunoglobulin Glambda biclonal gammopathy. Bone marrow biopsy showed involvement by classic Hodgkin lymphoma with an inflammatory background including 49% mature plasma cells. Unfortunately, the patient died 14 days after admission. To our knowledge, a case of concurrent Hodgkin lymphoma and biclonal multiple myeloma has not previously been reported. Detection of severe bone marrow plasmacytosis in the background of Hodgkin lymphoma should alert the pathologist to the possibility of collision with a plasma cell neoplasm, warranting a complete diagnostic workup.
霍奇金淋巴瘤和多发性骨髓瘤的诊断在同一患者中很少同时出现。我们报告了一例 82 岁男性患者，他迅速出现全血细胞减少、肝衰竭伴凝血功能障碍。血清蛋白电泳和免疫固定电泳显示明确的免疫球蛋白 Gkappa 和免疫球蛋白 Glambda 双克隆丙种球蛋白血症。骨髓活检显示经典霍奇金淋巴瘤浸润，伴有炎症背景，包括 49%成熟浆细胞。不幸的是，患者入院后 14 天死亡。据我们所知，以前没有报告过同时发生霍奇金淋巴瘤和双克隆多发性骨髓瘤的病例。在霍奇金淋巴瘤的背景下检测到严重的骨髓浆细胞增多症，应提醒病理学家注意与浆细胞肿瘤发生碰撞的可能性，需要进行全面的诊断性检查。
