Morphological and immunohistochemical investigation of non‐Hodgkin's lymphoma combined with Hodgkin's disease

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Abstract
Twenty cases with a morphological picture highly suspicious for a combination of non‐Hodgkin's lymphoma and Hodgkin's disease were investigated. The infiltrates of Hodgkin's disease differed from those of non‐Hodgkin's lymphoma in their cellular component of Hodgkin and Sternberg‐Reed cells and the irregularity in the fibre pattern. Based upon histological and immunohistochemical criteria the 20 cases were divided into three groups. Group 1 (n = 10) contained seven chronic lymphocytic leukaemias of B type, one lymphoplasmacytoid immunocytoma, and two centroblastic/centrocytic lymphomas. The non‐Hodgkin's lymphoma components showed a monotypic immunoglobulin distribution pattern and/or leukaemic blood picture. Adjacent to the non‐Hodgkin's lymphoma was typical Hodgkin's disease in which Hodgkin and Sternberg‐Reed cells were positive for both immunoglobulin light chains and IgG and reacted with anti‐CD15. Group 2 (n = 5) consisted exclusively of centroblastic/centrocytic lymphoma in combination with Hodgkin's disease in which the few Hodgkin and Sternberg‐Reed cells were negative with anti‐CD15 monoclonal antibody. Group 3 (n = 5) consisted of four chronic lymphocytic leukaemias of B type and one lymphoplasmacytoid immunocytoma. In these cases no combination with Hodgkin's disease could be diagnosed apart from the presence of partially CD15 positive Hodgkin and Sternberg‐Reed cells. The following conclusions were drawn: anti‐CD15 (LeuM1 and 3C4/C3D‐1) can neither confirm nor exclude Hodgkin's disease since, while they do not detect Hodgkin and Sternberg‐Reed cells in all cases of Hodgkin's disease, they do recognize Hodgkin and Sternberg‐Reed cells in some B‐cell lymphomas; anti‐CD30 (Ber‐H2) reacted with Hodgkin and Sternberg‐Reed cells in all cases of Hodgkin's disease and also detected these cells in cases of non‐Hodgkin's lymphoma.