Composite lymphomas consist of 2 or more different types of malignant lymphoma involving the same anatomic site.


Composite lymphomas may include:

(1) Hodgkin’s disease and a non-Hodgkin’s lymphoma

(2) B-cell and T-cell non-Hodgkin’s lymphoma

(3) 2 distinct types of B-cell lymphoma

(4) 2 distinct types of T-cell lymphomas


The 2 types of lymphoid neoplasms should be morphologically and phenotypically different.


The presence of 2 low-grade B-cell lymphomas may indicate biclonal lymphomas (Boiocchi et al)..


Differential diagnosis:

(1) Richter’s syndrome (second, more aggressive lymphoma arising in a patient with a pre-existing lymphoma)

(2) progression of lymphoma to a higher grade over time


The prognosis depends on the more unfavorable component so this should be the primary target for therapy.


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