Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2021; 9(30): 9159-9167
Published online Oct 26, 2021. doi: 10.12998/wjcc.v9.i30.9159
Hemophagocytic lymphohistiocytosis secondary to composite lymphoma: Two case reports
Jing Shen, Jing-Shi Wang, Jian-Lan Xie, Lin Nong, Jia-Ning Chen, Zhao Wang
Jing Shen, Jing-Shi Wang, Zhao Wang, Department of Hematology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing 100050, China
Jian-Lan Xie, Department of Pathology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing 100050, China
Lin Nong, Department of Pathology, Peking University First Hospital, Beijing 100034, China
Jia-Ning Chen, Department of Clinical Laboratory, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing 100000, China
Author contributions: Shen J and Wang JS conceived the topic, designed the study and revised the manuscript under the supervision of Wang Z; Shen J contributed to manuscript writing; Nong L contributed to data curation; Xie JL and Chen JN analyzed the data.
Informed consent statement: Consent was obtained from relatives of the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhao Wang, MD, Professor, Department of Hematology, Capital Medical University Affiliated Beijing Friendship Hospital, No. 95 Yongan Road, Xicheng District, Beijing 100050, China. wangzhao@ccmu.edu.cn
Received: April 1, 2021
Peer-review started: April 1, 2021
First decision: April 28, 2021
Revised: May 19, 2021
Accepted: July 2, 2021
Article in press: July 2, 2021
Published online: October 26, 2021
Processing time: 203 Days and 0.8 Hours
Core Tip

Core Tip: Lymphoma-associated hemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening clinical disorder. In particular, composite lymphoma with mixed lineage features of T- and B-cell marker expression is extremely rare. We report two cases of HLH secondary to bi-lineage composite lymphoma with lymphocyte infiltrations both in the bone marrow and lymph nodes in adult patients. Case 1 showed typical features of combined B-cell and T-cell lymphoma in axillary lymph node and bone marrow biopsies. Case 2 showed typical features of T cell lymphoma in lymph node biopsy, and B cell lymphoma in bone marrow biopsy. Both patients highlight the diagnostic dilemma, therapeutic challenges and poor prognosis of HLH secondary to composite lymphoma.