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American Journal of Medical Case Reports. 2021, 9(5), 298-300
DOI: 10.12691/AJMCR-9-5-10
Case Report

Grey Zone Lymphoma, Diagnostic and Therapeutic Challenges: A Rare Case Report

Eman EL-Sawalhy1, , Wehbi Hnayni1, Sarah Lonardo2 and Shahina Patel3

1Department of Internal medicine, Beaumont Hospital, Dearborn, MI

22Department of Hematopathology, Wayne State University School of Medicine, MI

3Division of Hematology & Oncology, Internal Medicine Department, Beaumont Hospital, Dearborn, MI

Pub. Date: March 14, 2021
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Cite this paper

Eman EL-Sawalhy, Wehbi Hnayni, Sarah Lonardo and Shahina Patel. Grey Zone Lymphoma, Diagnostic and Therapeutic Challenges: A Rare Case Report. American Journal of Medical Case Reports. 2021; 9(5):298-300. doi: 10.12691/AJMCR-9-5-10

Abstract

Grey zone lymphoma (GZL) remains a challenging diagnosis because it has mixed features of diffuse large B cell lymphoma (DLBCL) and classic Hodgkin lymphoma (cHL). In this case report, we present a 69-year-old man who was diagnosed with GZL after an incidental finding of right axillary lymphadenopathy on Computed tomography (CT) scan during a recent hospitalization for an ischemic stroke. Excisional biopsy of the axillary node pathology was consistent with classic Hodgkin lymphoma (Nodular Sclerosing type). Subsequent Positron Emission Tomography (PET)/CT scan showed adenopathy above and below the diaphragm, as well as possible liver, bone, and colon disease. Liver biopsy revealed pathology consistent with DLBCL contrary to the Hodgkin disease seen on axillary biopsy resulting in an eventual diagnosis of GZL on further pathology review.

Keywords

Grey zone lymphoma, B cell Lymphoma, classic Hodgkin Lymphoma

Copyright

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]  Egan, Caoimhe, and Stefania Pittaluga. “Into the Gray-Zone: Update on the Diagnosis and Classification of a Rare Lymphoma.” Expert Review of Hematology, 30 Nov. 2019, vol. 13, no. 1, pp. 1-3, 10.
 
[2]  Pilichowska, Monika, et al. “Clinicopathologic Consensus Study of Gray Zone Lymphoma with Features Intermediate between DLBCL and Classical HL.” Blood Advances, 12 Dec. 2017, vol. 1, no. 26, pp. 2600-2609.
 
[3]  Pak, Stella. “A Case Report: Remission of Gray Zone Lymphoma on R-CHOP and Adjuvant Radiation Treatment.” Journal of Cancer Science and Clinical Therapeutics, 4 Dec. 2017, vol. 1, no. 1, pp. 19-21.
 
[4]  Mallipudi, Rajiv M., et al. “A Rare Case of Grey Zone Lymphoma Successfully Treated with Brentuximab Vedotin and R-CHP Chemotherapy.” Case Reports in Oncological Medicine, 11 Apr. 2019.