HODGKIN’S DISEASE VARIANT OF RICHTER’S SYNDROME: A CASE REPORT WITH REVIEW OF THE LITERATURE

Abstract

The transformation chronic lymphocytic leukemia (CLL) into Richter syndrome represents aggressive clinical evolution of CLL. In most cases, this transformation corresponds to diffuse large B-cell lymphoma, but in very rare cases it can lead to Hodgkin's Disease Variant of Richter's Syndrome. We report a case of CLL transformed into Hodgkin's disease type of Richter's Syndrome in a 70-year-old male patient. Microscopic examination showed the presence of large tumor cells with the morphological and immunophenotypic features in favor of classical Hodgkin and Reed-Sternberg cells. The transformation of CLL into Hodgkin's disease poses a problem of histogenetic diagnosis. According to the literature, the clonal relationship between CLL and Hodgkin's disease is likely with prognostic value. Two forms of Hodgkin's Disease Variant of Richter's Syndrome are described with different prognoses: a form that corresponds to a true transformation of the CLL into a Hodgkin's disease, a poor prognosis and a second form that corresponds to the co-existence of CLL and Hodgkin's disease with better prognosis.