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Three coexisting lymphomas in one patient: genetically related or only a coincidence?
  1. M Steinhoff1,
  2. C Assaf1,
  3. I Anagnostopoulos2,
  4. C C Geilen1,
  5. H Stein2,
  6. M Hummel2
  1. 1Department of Dermatology and Allergy, Charité–Universitaetsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
  2. 2The Institute of Pathology, Charité–Universitaetsmedizin Berlin
  1. Correspondence to:
 M Steinhoff
 Department of Dermatology and Allergy, Charité–University Medicine Berlin, Campus Benjamin Franklin, Fabeckstrasse 60–62, Berlin 14195, Germany;matthias.steinhoff{at}


The simultaneous manifestation of different lymphomas in the same patient or even in the same tissue, defined as composite lymphoma, is very rare. The exceptional case of a patient who, presented with simultaneous manifestation of three different lymphomas after 30 years of successful treatment of a nodal T cell lymphoma is reported here. The three lymphomas were: (1) primary cutaneous marginal zone B cell lymphoma (MZBL); (2) nodal Epstein–Barr virus (EBV)-associated classic Hodgkin’s lymphoma (cHL) of the B cell type; and (3) peripheral T cell lymphoma coexisting in the skin and cervical lymph node. Immunohistochemical and molecular analyses showed different clonal origins of EBV-negative cutaneous MZBL and EBV-positive B cell cHL and, in addition, the presence of the same clonal T cell population in the skin and lymph node. The simultaneous occurrence of three different, clonally unrelated lymphomas in one patient at the same time has not been reported yet.

  • ALPS, autoimmune lymphoproliferative syndrome
  • APAAP, alkaline phosphatase anti-alkaline-phosphatase
  • cHL, classic Hodgkin’s lymphoma
  • EBV, Epstein–Barr virus
  • HRS, Hodgkin’s and Reed–Sternberg
  • IgH, immunoglobulin H
  • MZBL, marginal zone B cell lymphoma
  • TCL, T cell lymphoma
  • TCR, T cell antigen receptor

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  • Competing interests: None.