Contributions
Abstract: PB2019
Type: Publication Only
Background
Patients with inflammatory bowel disease (IBD) on immunosuppression are at risk of developing lymphoma, particularly primary gastrointestinal (GI) Non-Hodgkin lymphoma. Primary GI Hodgkin lymphoma (HL) in this setting is a rare and poorly defined clinical entity.
Aims
We report on a patient with Crohn disease (CD) who developed GI HL and review the available literature.
Methods
An electronic search of Medline, updated to December 2017, was performed .Each paper was reviewed and duplicate reports describing the same patients were included just once.
Results
Ten single-case studies and 6 case-series, published between 1978-2016, involving 23 patients ,were identified. Twenty-one (91%) patients had CD, whilst two others had ulcerative colitis. Eighteen (79%) patients were male, with a median age of 39 at lymphoma diagnosis. Diagnosis of HL occurred at a median of 8 and 4.4 years after the detection of IBD and commencing immunosuppression, respectively. HL had a predilection (80%) to involve the inflamed GI site. The histological subtype was mixed cellularity in 65% of cases and in-situ hybridization for EBV-encoded RNA, when documented, was positive in all cases. Thirty-five, 20%, 5% and 40% of patients were diagnosed in stage 1 to 4, respectively. Interestingly, 66% of patients with advanced disease had liver involvement. Immunosuppression was stopped in most (70%) patients upon lymphoma diagnosis. HL treatment consisted of chemotherapy only, surgery followed by chemotherapy or surgery only in 50%, 33% and 16% of cases, respectively. Four patients had IBD flare during HL remission.
Conclusion
Patients with IBD who develop HL with GI involvement have distinct characteristics: male predominance, a predilection for inflamed GI sites, mixed cellularity histological subtype, EBV positivity, and a unique pattern of spread to the liver.
Session topic: 17. Hodgkin lymphoma – Clinical
Keyword(s): EBV, Hodgkin's Lymphoma, inflammation
Abstract: PB2019
Type: Publication Only
Background
Patients with inflammatory bowel disease (IBD) on immunosuppression are at risk of developing lymphoma, particularly primary gastrointestinal (GI) Non-Hodgkin lymphoma. Primary GI Hodgkin lymphoma (HL) in this setting is a rare and poorly defined clinical entity.
Aims
We report on a patient with Crohn disease (CD) who developed GI HL and review the available literature.
Methods
An electronic search of Medline, updated to December 2017, was performed .Each paper was reviewed and duplicate reports describing the same patients were included just once.
Results
Ten single-case studies and 6 case-series, published between 1978-2016, involving 23 patients ,were identified. Twenty-one (91%) patients had CD, whilst two others had ulcerative colitis. Eighteen (79%) patients were male, with a median age of 39 at lymphoma diagnosis. Diagnosis of HL occurred at a median of 8 and 4.4 years after the detection of IBD and commencing immunosuppression, respectively. HL had a predilection (80%) to involve the inflamed GI site. The histological subtype was mixed cellularity in 65% of cases and in-situ hybridization for EBV-encoded RNA, when documented, was positive in all cases. Thirty-five, 20%, 5% and 40% of patients were diagnosed in stage 1 to 4, respectively. Interestingly, 66% of patients with advanced disease had liver involvement. Immunosuppression was stopped in most (70%) patients upon lymphoma diagnosis. HL treatment consisted of chemotherapy only, surgery followed by chemotherapy or surgery only in 50%, 33% and 16% of cases, respectively. Four patients had IBD flare during HL remission.
Conclusion
Patients with IBD who develop HL with GI involvement have distinct characteristics: male predominance, a predilection for inflamed GI sites, mixed cellularity histological subtype, EBV positivity, and a unique pattern of spread to the liver.
Session topic: 17. Hodgkin lymphoma – Clinical
Keyword(s): EBV, Hodgkin's Lymphoma, inflammation