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22 December 2021: Articles

Rare Richter Transformation of Chronic Lymphocytic Lymphoma to Hodgkin Lymphoma

Challenging differential diagnosis, Rare disease, Rare coexistence of disease or pathology

Tinera Buckley ** , Arati Inamdar * , Nagyl H. Mikhail A , Abraham Loo A , Seth Cohen A

DOI: 10.12659/AJCR.932904

Am J Case Rep 2021; 22:e932904

Figure 4. Richter transformation to classic Hodgkin lymphoma: (A) Low-power H&E-stained image showing the periportal area (blue oval) infiltrated by inflammatory cells and histiocytes causing granuloma, with adjacent area (red oval) showing the large, atypical cells infiltrating the liver parenchyma. (B) High-power H&E-stained image showing the large atypical binucleated to multinucleated Reed-Sternberg cells (arrow). (C) RS cells with no reactivity to ALK immunostaining (arrow). (D) RS cells (long arrow) with weak reactivity for Pax-5 but diffuse reactivity for background clonal/CLL-specific B cells (arrowhead). (E, F) The intense reactivity for CD 30 and CD 15 by RS (arrows) confirms the CLL transformation to CHL, respectively. (G) The background CLL cells showed weak CD 20 reactivity (arrow) and negative activity in RS cells (arrowhead). (H) Both RS cells (arrow) and CLL B cells (arrowhead) showed positive Bcl-2 reactivity and (I) positive reactivity for Eber-ISH was seen only in RS cells (arrow).

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923