Primary Gastric Hodgkin’s Lymphoma in a Patient with Chronic Lymphocytic Leukemia: A Case Report and Review of the Literature

Abstract Several malignancies can present with gastric ulcers and gastrointestinal (GI) bleeding, including gastric carcinoma and lymphoma. The GI tract is the most common site for extranodal non-Hodgkin lymphoma. Here, we present a very rare case of Hodgkin lymphoma that presented as gastric ulcers. An 85-year-old male patient with prior history of chronic lymphocytic leukemia presented with syncope, melena, and severe anemia. An upper esophagogastroduodenoscopy was performed to investigate GI bleeding. Endoscopy showed multiple superficial stomach ulcerations which were biopsied. Biopsy of the stomach ulcerations showed Helicobacter pylori gastritis in addition to an atypical lymphoid infiltrate containing large cells with prominent nucleoli that were positive for CD30, CD15, PAX-5, and MUM-1, consistent with classic Hodgkin lymphoma. Hodgkin lymphoma of the GI tract is exceedingly rare. On searching the literature, we only found a few (<10) cases that presented with gastric ulcers. While H . pylori infection is known to be associated with marginal zone lymphoma, there is no known association with Hodgkin lymphoma. Appropriate immunohistochemical studies should be used to achieve the correct diagnosis.