DOI: 10.36347/SJMCR.2019.v07i11.009

Pages: 675-679

Epstein–Barr virus (EBV) can be associated with both classical Hodgkin lymphoma (cHL) and non-Hodgkin lymphoma of the B-cell type, particularly in immunodeficient patients or elderly individuals. While polymorphic variants of EBV-positive large B-cell lymphoma (EBV+ DLBCL) frequently resemble Chl in morphology, and thereby may cause diagnostic difficulty, a true gray zone lymphoma with overlapping morphological and immunophenotypical features of EBV+ DLBCL and EBV+ cHL has not been reported in the literature. We describe a unique case of 63-year-old patient followed since 2015 for mixed Stage IIIB, IPS-3 Hodgkin lymphoma. Initially treated with 6 BEACOPPe procedures, with partial remission at the end. The disease remained in control until July 2019, when the patient presents with general signs (night sweats and slimming). The clinical examination finds isolated hepatomegaly. Following hepatic biopsy, analysis of morphological data and immunohistochemical study results, especially the intense and diffuse CD20 positivity and the negativity of CD15, led to the diagnosis of EBV-positive EBV positive EBV-positive large B-cell lymphoma. It has been documented that EBV plays a crucial role in the pathogenesis of both cHL and some cases of DLBCL, particularly in immune compromised patients [14, 17, 18]. However, the detailed mechanisms by which the virus transforms the B-cells into two distinctive lymphoid neoplasms remain to be elucidated.