Hodgkin's disease variant of Richter's syndrome. Report of eight cases

Abstract

Large cell lymphoma associated with chronic lymphocytic leukemia (CLL)--Richter's syndrome--is a well-recognized entity. Rarely, Hodgkin's or "Hodgkin's-like" lymphoma associated with CLL has been reported. The authors present the clinicopathologic findings in eight cases of well-documented CLL in which solid tumors with histologic and immunostaining features of Hodgkin's disease subsequently developed. The histologic patterns observed in these tumors included nodular sclerosing (four cases) and mixed cellularity (four cases). In all eight cases, diagnostic Reed-Sternberg cells stained strongly with antibody to Leu-M1/CD15 but showed no reactivity with antibody to leukocyte common antigen (LCA/CD45). Survival ranged from 2 months to more than 8 years, with a 50% cumulative survival of 12 months; this is in contrast to the 2- to 4-month survival that typifies non-Hodgkin's Richter's syndrome. Therefore, it is important to recognize the Hodgkin's subgroup of lymphomatous CLL transformation.