Transformation of follicular lymphoma into classical Hodgkin lymphoma showing t(14;18)


Follicular lymphomas (FLs) are B-cell lymphomas with a generally indolent clinical course with the propensity to transform to higher grade lymphomas. Most commonly, FL transforms into diffuse large B-cell lymphoma (DLBCL), but transformation to other higher-grade B-cell lymphomas has also been described. Transformation to classical Hodgkin lymphoma (cHL) has been documented only anecdotally. Here we describe five patients diagnosed with FL and also subsequently or synchronously with cHL. For each patient, we demonstrate the clonal relationship between the FL and the cHL by the identification of t(14;18) in both the FL and in the Hodgkin-Reed-Sternberg (HRS) cells, if available. Aneuploidy and atypical expression of BCL2 was commonly seen in the HRS cells. After transformation to cHL, the lymphomas demonstrated a more aggressive clinical behavior. In conclusion, we report five cases of FL with clonal transformation to cHL and aggressive clinical behavior that typifies other more frequently encountered transformed B-cell lymphomas.


Classical Hodgkin lymphoma, follicular lymphoma, t(14;18), transformation

How to Cite

Wang, X. J. & Griffin, G. K. & Yenamandra, A. & Wheeler, F. C. & Ligon, A. H. & Nandedka, M. A. & Shaheen, S. P. & Mosse, C. A. & Kim, A. S., (2016) “Transformation of follicular lymphoma into classical Hodgkin lymphoma showing t(14;18)”, Hematopathology 1(1), 23-33.


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Xuan J. Wang (Vanderbilt University Medical Center)
Gabriel K. Griffin (Brigham and Women’s Hospital, Boston MA)
Ashwini Yenamandra (Vanderbilt University Medical Center)
Ferrin C. Wheeler (Vanderbilt University Medical Center)
Azra H. Ligon (Brigham and Women’s Hospital, Boston MA)
Meenakshi A. Nandedka (Joint Pathology Center, Silver Spring, MD)
Saad P. Shaheen (University of Louisville)
Claudio A. Mosse (Vanderbilt University Medical Center)
Annette S. Kim (Vanderbilt University Medical Center)



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