Primary classical Hodgkin lymphoma (mixed cellularity) of stomach presenting multiple polyps

Abstract

Backgrounds: Only a few cases of primary classical Hodgkin lymphoma (CHL) are reported previously in stomach. Case: A 77-year-old man presented epigastralgia and received an upper gastrointestinal endoscopy, which revealed multiple polyps. Biopsies (endoscopic mucosal resection) from the lesions showed proliferation of Hodgkin cells (HC) and Reed-Sternberg giant cells (RSC) mixed with non-tumorous inflammatory infiltrates composed of lymphocytes, plasma cells, neutrophils, and histiocytes. Immunohistochemically, the tumor cells (HC and RSC) showed the following immunophenotypes: cytokeratin -, CD45 +++, CD20 +++, CD10 ++. CD79a ++, CD138 +, CD3 -, CD45RO -, CD56 -, CD68 +++, CD30 -, CD15 +++, PAX5 ++, kappa-chain -, lamda-chain -, bcl-2 -, Ki67 20%, p53 +++, vimentin +++, CD68 +++, EMA -, CEA -, S100 protein -, smooth muscle actin -, CD31-, CD34-, factor 8 -, CEA -, EBER -, EBV-latent membrane protein1 -, and EBNA2 -. Immunostainings of endothelial antigens (CD31, CD34, smooth muscle actin, and factor 8-related antigen) showed negative results. A pathological diagnosis of CHL of mixed cellularity type was made, and the patient has first ABVD chemotherapy and then radiation. Conclusion: A very rare case of primary gastric CHL presenting multiple gastric polyps is reported.