↓ Figure 1. Brain MRI showing a parietal mass identified as PCNSL (red arrow) on stereotactic brain biopsy. PCNSL: primary diffuse large B-cell lymphoma of the central nervous system; MRI: magnetic resonance imaging.
| Journal of Hematology, ISSN 1927-1212 print, 1927-1220 online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Hematol and Elmer Press Inc |
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Case Report
Volume 15, Number 3, June 2026, pages 169-177
Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System and Systemic Classic Hodgkin Lymphoma in the Same Patient
Figures
Table
| Case No. | Reference | Age/gender | Site involvement (components) | Treatment | Response | Survival status |
|---|---|---|---|---|---|---|
| F: female; M: male; DLBCL: diffuse large B cell lymphoma; HL: Hodgkin lymphoma; ProMACE: prednisone, methotrexate, doxorubicin, cyclophosphamide, etoposide; MOPP: mechlorethamine, vincristine, and procarbazine; CHOP: cyclophosphamide, doxorubicin, vincristine, prednisone or prednisolone; R-CHOP: rituximab and CHOP; Pro-MACE-Cyta-BOM: Pro-MACE and cytarabine, bleomycin, vincristine and methotrexate; MACOP-B: methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone and bleomycin; BEAM: BCNU, etoposide, Ara-C, and melphalan; R-CHOEP: R-CHOP and etoposide; ABVD: doxorubicin, bleomycin, vinblastine, and dacarbazine; MRT: methotrexate, rituximab, temozolomide; Nivo-AVD: nivolumab, Adriamycin, vinblastine, dacarbazine; ASCT: autologous stem cell transplantation; CR: complete remission; PR: partial response. | ||||||
| 1 | Kim et al, 1977 [3] | 40/F | Splenic hilar and axillary lymph nodes (DLBCL) + hepatoduodenal lymph nodes (HL) | Chemotherapy and radiation (unknown) | Unknown | Death, 48 months after CL diagnosis, with evidence of disease on autopsy |
| 2 | Guarner et al, 1990 [4] | 44/M | Retroperitoneal lymph nodes (DLBCL and HL) + liver and spleen | ProMACE/MOPP | Unknown | Death, 6 months after CL diagnosis, with no evidence of disease on autopsy |
| 3–8 | Gonzalez et al, 1991 [5] (6 cases) | 66/M | Cervical lymph node (DLBCL and HL) | Cyclophosphamide, vincristine, bleomycin | Unknown | Lost to follow-up |
| 43/M | Supraclavicular lymph node (DLBCL and HL) | Multiagent chemotherapy and ASCT | Unknown | Death, 26 months after CL diagnosis | ||
| 63/M | Stomach (DLBCL and HL) | Surgery | Unknown | Death, 2 months after CL diagnosis | ||
| 62/F | Inguinal lymph node (DLBCL and HL) | Local radiation | CR | Alive, 27 months after CL diagnosis, with no evidence of disease | ||
| 22/M | Cervical lymph node (DLBCL and HL) | Cyclophosphamide, cisplatin, prednisone, carmustine | Unknown | Death, 6 months after diagnosis of CL | ||
| 25/M | Mediastinum (DLBCL and HL) | Multiagent chemotherapy | CR | Alive, 3 months after diagnosis of CL | ||
| 9 | Paulli et al, 1992 [6] | 37/M | Supraclavicular lymph node (DLBCL and HL) | Pro-MACE-Cyta-BOM | CR | Alive, 24 months after diagnosis of CL, with no evidence of disease |
| 10 | Bellan et al, 2002 [7] | 29/F | Cervical lymph node (DLBCL and HL) | MACOP-B, BEAM, radiation and ASCT | CR | Alive, 30 months after therapy completion, with no evidence of disease |
| 11 | Rosenquist et al, 2004 [8] | 74/F | Inguinal lymph node (DLBCL and HL) | R-CHOP | PR | Alive, 12 months after diagnosis of CL |
| 12 | Wei et al, 2004 [9] | 26/F | Mediastinum (DLBCL and HL) | CHOP | PR | Unknown |
| 13 | Huang et al, 2006 [10] | 56/M | Small intestine (DLBCL and HL) + bone marrow (HL) | Surgery | Unknown | Death, 20 days after diagnosis of CL |
| 14 | Miyagaki et al, 2009 [11] | 75/M | Inguinal lymph nodes (DLBCL and HL) | 6 cycles of R-CHOP | CR, death at 36 months but no recurrence | Death, 36 months after diagnosis of CL |
| 15 | Khanna et al, 2010 [12] | 58/M | Aortic valve (DLBCL) + mitral valve (HL) + spleen (HL) | Surgery + R-CHOP + ProMACE | CR | Unknown |
| 16 | Yu et al, 2011 [13] | 37/F | Anterior mediastinum and lung tissue (DLBCL and HL) | Surgery + CHOP | CR | Alive, 33 months after surgery |
| 17 | Wang et al, 2013 [14] | 53/F | Gastric perigastric lymph nodes (DLBCL) + pylorus and parapyloric lymph nodes (HL) | Surgery + 8 cycles CHOP + 2 cycles R-CHOP | CR | Death, 11 months after surgery, with recurrence of disease at 7 months |
| 18 | Goyal et al, 2016 [15] | 79/F | Colon (DLBCL) + mesenteric lymph nodes (HL) | R-CHOP | CR | Alive, 12 months after CL diagnosis |
| 19 | Auditeau et al, 2018 [16] | 70/M | Bone marrow (DLBCL and HL) | 1 cycle of COP + 2 cycles of ABVD and etoposide + 3 cycles of R-CHOEP | Unknown | Death |
| 20 | Wang et al, 2020 [17] | 64/M | Cervical lymph nodes (DLBCL and HL) | 6 cycles of R-CHOP + 2 cycles of rituximab | CR | Alive, 9 months after therapy with no evidence of disease |
| 21 | Esper et al, 2021 [18] | 67/M | Axillary lymph node (DLBCL and HL) | 2 cycles of ABVD + 11 cycles of R-CHOP | PR | Death, 2 months after completion of therapy, with evidence of recurrence |
| 22 | Ryder et al, 2023 [19] | 54/M | Inguinal lymph node (DLBCL and HL) | 6 cycles of R-CHOP + 5 cycles on clinical trial (loncastuximab plus rituximab vs rituximab, gemcitabine, and oxaliplatin) + brentuximab vedotin and nivolumab | CR | Unknown, plans for ASCT |
| 23 | Lee et al, 2025 [20] | 20/M | Kidney (DLBCL) + cervical lymph node (HL) | 6 cycles R-CHOP + intrathecal methotrexate for CNS prophylaxis + BEAM and ASCT | CR | Alive, 40 months after completion of therapy, with no evidence of disease |
| 24 | Current case | 66/M | Brain (PCNSL) + cervical lymph nodes (HL) | 10 cycles of MRT (rituximab discontinued cycle 4) + 2 cycles methotrexate + 1 cycle Nivo-AVD + 1 cycle bendamustine + BEAM and ASCT | CR | Alive, 12 months after completion of therapy, with no evidence of disease |