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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