37 yrs male.
HISTORY: 2007 CHL diagnosed outside (NOT INCLUDED GRAPHICS THERE). Chemo-radio therapy was applied (no details known).
RELAPSE 2011 (1)(NOT INCLUDED GRAPHICS THERE): cHL NS 1 with IH: CD15/CD30+; CD20/CD79a/CD3(-). BM biopsy: negative. 2012 pulmonary (postterapy) resectiom: BOOP only.
RELAPSE 2014 (2)(neck LN): the same cHL NS 2 picture with IH: CD30+ > CD15+; CD20/CD3/CD2/LCA+ (aberant); Oct2/BOB1(-); Pax5+/-(weak); ALK1/CD79a(-).
TREATMENT: 1. BEACOPP chemo+ radio. 2. ICE chemo+ 2/double autologous Tx (2011 09 15 and 2012 01 12). 3. Radiotherapy of involved fields (PET guiding).
SPECIAL POINT OF INTEREST:
a) Genesis of "globular: and abberant expression of T Ags and Igs K >> L.
b) CD20 and LCA aquisition (another clone? oth.?) in line with progression/large cell enumeration/NS2?.
c) Eosinophilic RCC like cytoplasmic inclussions (maybe accumulation of proteins/fillaments with abberant IH?).
d) Association with unfavourable course?
Literature mainstay:
1. Venkataraman G, Song JY, Tzankov A et al. Aberrant T-cell antigen expression in classical Hodgkin lymphoma is associated with decreased event-free survival and overall survival: http://www.ncbi.nlm.nih.gov/pubmed/23305738 {PMID: 23305738}
2. Tzankov A, Bourgau C, Kaiser A et al. Rare expression of T-cell markers in classical Hodgkin's lymphoma: http://www.ncbi.nlm.nih.gov/pubmed/16056244 {PMID: 16056244}