MEDIASTINAL COMPOSITE LYMPHOMA COMPOSITE LYMPHOMA IN SUPERIOR MEDIASTINUM OF PRIMARY MEDIASTINAL B-CELL LYMPHOMA AND CLASSICAL HODGKIN LYMPHOMA

*Abotaleb Alia A. MD and Bin Abbas Elham S. MBBS

ABSTRACT

Composite lymphoma (CL) of primary mediastinal B-cell lymphoma (PMBCL) and classical Hodgkin’s lymphoma (CHL) is extremely rare specially in this age groups. In this article, we report a case of CL initially diagnosed as diffuse large B-cell lymphoma NOS, and CHL, then turned out as PMBCL with CHL. 14-year-old boy presented with several months of progressive cough, dyspnea, and generalized pruritus. Found to have massive left pleural effusion with lung collapse, computed tomographic imaging done which revealed large superior/ anterior mediastinal mass with multiple mediastinal lymphadenopathies as well as pleural, pericardial effusion along with lesions in kidneys. The patient underwent an excisional biopsy from the mediastinal lymph node, which found to have a composite lymphoma of CHL and PMBCL. He successfully treated with chemotherapy dose-adjusted EPOCH-R (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab) and currently on regular follow up.

Keywords: CHL, Composite lymphoma, EPOCH-R, mediastinum, PMBCL.