case_images: PMC11407883_01
case_images: Composite lymphoma with co-existence of classic (grade 1 to 2) follicular lymphoma (a-c), EBV-positive classic Hodgkin lymphoma (d-f), and EBV-positive nodal T- and NK-cell lymphoma (g-i) in a left groin lymph node. (a) Section shows a neoplastic follicle composed of predominantly centrocytes (H&E, X20). (b) The neoplastic follicle contains dendritic cell meshworks as confirmed by IHC (CD21, X20). (c) Follicular cells are positive for BCL-2 as demonstrated by IHC (BCL-2, X20). (d) Section shows large Hodgkin/Reed-Sternberg-like cells and variants (H&E, X20). (e) The neoplastic cells are positive for CD30 as demonstrated by IHC (CD30, X20). (f) The neoplastic cells contain EBV as demonstrated by EBER in situ study (EBER in situ, X20). (g) Section shows a diffuse infiltration of large atypical lymphoid cells (H&E, X20). (h) The neoplastic cells are positive for CD8 as demonstrated by IHC (CD8, X20). (i) The neoplastic cells contain EBV as demonstrated by EBER in situ study (EBER in situ, X20). H&E, Hematoxylin and Eosin. IHC, immunohistochemical stain.
case_images: CRIHEM2024-8810646.001.jpg
case_images: PMC11407883_01_CRIHEM2024-8810646.001.jpg
case_images: fig1
case_images: Inguinal lymph node excisional biopsy showed a composite lymphoma comprised of clonally distinct EBV-positive cHL, nodular sclerosis type (occupying 40-50% of lymph node space), EBV-positive primary nodal TNKL (50-60%), and classic (grade 1-2) FL (1-2%) (Figure 1).