PMC4785670_01
PMC4785670_02
Histology of the bone marrow biopsy at the diagnosis CVID-associated classic Hodgkin lymphoma. a Photomicrograph of the infiltrate in the marrow comprising very large Hodgkin and Reed-Sternberg (HRS) cells in a fibroinflammatory background (Hematoxylin and eosin stain, 1000X). b & c CD30 and CD20 immunohistochemistry is positive in HRS cells respectively (3',3'-diaminobenzidine chromogen with hematoxylin counterstain, 1000X). d In situ hybridization for Epstein-Barr-virus-encoded RNA 1 (EBER 1) is positive in HRS cells (INFORM EBER probe and iVIEWTMblue detection, Ventana Medical Systems, Inc., Tuscon, AZ. 1000X)
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PMC4785670_02_40364_2016_61_Fig1_HTML.jpg
Fig1
The abnormal cells were large cells positive for CD30, CD15, CD20 (weak to moderate), and PAX-5 (weak), EBER positive (Fig. 1).
PET scan prior to and post treatment. a PET scan on initial diagnosis of CVID-associated classic Hodgkin lymphoma. b Post 4 weekly doses of rituximab. c Prior to brentuximab vidotin. d Post brentuximab
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PMC4785670_02_40364_2016_61_Fig2_HTML.jpg
Fig2
In addition, there were hypermetabolic sclerotic lesions within the bone marrow of L3 and the left iliac bone (Fig. 2a). However, there was only a partial metabolic response of the lesions in the left iliac bone, vertebral bodies T9 and L3 (Fig. 2b). Repeat PET/CT in June 2014 showed resolution of the L3 lesion, but revealed new sites of osseous disease in the right humerus, left posterior 5th rib, left 10th spinous process, mid sacrum, right iliac wing, and left femoral head (Fig. 2c). A follow-up PET/CT in December 2014 showed a complete metabolic response (Fig. 2d).