A patient with nodular lymphocyte-predominant Hodgkin's lymphoma may progress to an aggressive form of non-Hodgkin's lymphoma such as diffuse large B-cell lymphoma (DLBCL). The authors are from the British Columbia Cancer Agency in Vancouver.
Risk factor for transformation:
(1) splenic involvement at the time of Hodgkin's disease diagnosis
Clinical findings seen with transformation:
(1) rapid clinical deterioration
(2) onset of new B symptoms
(3) involvement of unusual extranodal sites
Laboratory findings suggesting transformation:
(1) sudden increase of serum LDH to >= 2 times the upper limit of the normal reference range
Definitive diagnosis is based on a biopsy showing an aggressive malignant lymphoma.
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