Abstract：
The co-occurrence of several lymphomas in a patient defines composite/synchronous lymphoma. A common cellular origin has been reported for both contingents of such entities. In the present review, we aimed to gather the available data on composite lymphomas associating a classical Hodgkin lymphoma (cHL) with another lymphoma, to better understand the plasticity of mature B and T-cells. This review highlights that >70% of patients with a composite lymphoma are ≥55 years old, with a male predominance. The most reported associations are cHL with follicular lymphoma or diffuse large B-cell lymphoma, with over 130 cases reported. The cHL contingent is often of mixed cellularity type, with a more frequent focal/weak CD20 expression (30% to 55.6%) compared to de novo cHL, suggesting a particular pathophysiology. Moreover, Hodgkin cells may express specific markers of the associated lymphoma (e.g., BCL2/BCL6 for follicular lymphoma and Cyclin D1 for mantle cell lymphoma), sometimes combined with common BCL2/BCL6 or CCND1 rearrangements, respectively. In addition, both contingents may share similar IgH/IgK rearrangements and identical pathogenic variants, reinforcing the hypothesis of a common clonal origin. Finally, cHL appears to be endowed with a greater plasticity than previously thought, supporting a common clonal origin and a transdifferentiation process during lymphomagenesis of composite lymphomas.
摘要：
患者中几种淋巴瘤的共同出现定义了复合/同步淋巴瘤。据报道，这两个实体的特遣队都有共同的细胞起源。在本次审查中，我们的目的是收集有关复合淋巴瘤的现有数据，将经典霍奇金淋巴瘤（cHL）与另一种淋巴瘤相关联，更好地了解成熟B细胞和T细胞的可塑性。这篇综述强调，70%的复合淋巴瘤患者年龄≥55岁，男性占主导地位。报道最多的是cHL与滤泡性淋巴瘤或弥漫性大B细胞淋巴瘤，报告了130多例。cHL队伍通常是混合细胞类型，与从头cHL相比，局灶性/弱CD20表达更频繁（30％至55.6％），暗示了一种特殊的病理生理学。此外，霍奇金细胞可能表达相关淋巴瘤的特异性标志物(例如，BCL2/BCL6用于滤泡性淋巴瘤，CyclinD1用于套细胞淋巴瘤），有时结合常见的BCL2/BCL6或CCND1重排，分别。此外,两个特遣队可能共享相似的IgH/IgK重排和相同的致病变异，加强共同克隆起源的假设。最后,cHL似乎比以前认为的具有更大的可塑性，在复合淋巴瘤的淋巴形成过程中支持共同的克隆起源和转分化过程。
