Composite lymphoma associating diffuse large B-cell lymphoma with classical Hodgkin lymphoma

[摘要] A 55-year-old man with a 1-month history of asthenia, right hypochondrial pain, and weight loss was referred to the emergency departmentfor hepatic mass evaluation. Besides hypertension, he had no relevantpre-existing conditions.Physical examination revealed a palpable right inguinal lymphnode. Complete blood count was normal apart from mild leukocytosis (15.2 × 109/l, N: 3.5–10.0 × 109/l) with neutrophilia. Liver functiontests were altered (gamma-glutamyl transferase: 134 U/l, N: 8–61 U/l;alkaline phosphatase: 167 U/l; N: 40–129 U/l). C-reactive protein levelwas elevated at 104 mg/l (N: <5 mg/l). Lactate dehydrogenase waswithin normal ranges. Abdominal computed tomography scan revealeda large necrotic mass in the liver, a second necrotic mass adjacentto the superior mesenteric vessels, and numerous subdiaphragmaticlymph nodes (aorta, right kidney, retro-crural, mesenteric, iliac, andinguinal). Hypermetabolic activity was confirmed by positron emissiontomography.

[关键词] classical Hodgkin lymphoma;composite lymphoma;diffuse large B-cell lymphoma