Rare case of classic Hodgkin lymphoma in a patient with ulcerative colitis

Abstract

Primary gastrointestinal tract lymphoma (PGIL) is a rare form of presentation of gastrointestinal tract (GI) lymphomas. Inflammatory bowel disease (IBD) and the use of thiopurines are known risk factors for its appearance. We report a male patient in his early 70s treated only with mesalamine for ulcerative colitis (UC) for the past 6 years. He was admitted due to COVID-19 and anaemia secondary to massive haematochezia. The patient underwent total colectomy with end ileostomy, with intraoperative proctoscopy. Tissue biopsy demonstrated typical features of UC; however, atypical lymphoid proliferation of the regional lymph nodes with histological and immunochemical staining results was suggestive of classic Hodgkin lymphoma, nodular sclerosis subtype. The patient was treated with adriamycin, vinblastine and dacarbazine chemotherapy initially successful after 1 session but later opted for palliative care. Due to its rarity, lymphoid neoplasms occurring in the context of IBD are poorly known.