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A 73 year-old woman with ulcerative colitis (UC) was steroid-dependent, showing disease exacerbation when prednisolone was tapered or discontinued. Azathioprine was administered eight years prior but was discontinued after a short period due to liver dysfunction. Vedolizumab was initiated 31\u00a0months before presentation. Despite initial improvements in UC with vedolizumab, hematochezia subsequently persisted. Other biologics or immunomodulators that could cause systemic immunosuppression were avoided because she was receiving treatment for breast cancer. Colonoscopy showed erosions in the transverse colon and an ulcerative lesion in the sigmoid colon. A biopsy revealed high-grade dysplasia in the transverse colon and inflammatory granulation tissue without malignancy in the sigmoid lesion; therefore, surgery was indicated. Laparoscopic total proctocolectomy was performed, and the surgical specimen contained Reed\u2013Sternberg cells positive for CD20, CD30, PD-L1, and EBV-encoded RNA, establishing EBV-associated cHL. Although the development of cHL is likely multifactorial, clinicians should be aware that EBV-associated intestinal cHL may develop in patients with UC receiving vedolizumab when tumor-like ulcers or mural thickening are encountered.<\/jats:p>","DOI":"10.1007\/s12328-026-02302-7","type":"journal-article","created":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:56:44Z","timestamp":1772254604000},"page":"509-515","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Classic hodgkin lymphoma associated with Epstein\u2013Barr virus reactivation during vedolizumab therapy for ulcerative colitis"],"prefix":"10.1007","volume":"19","author":[{"given":"Tatsuya","family":"Hasegawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8130-2403","authenticated-orcid":false,"given":"Masatsugu","family":"Kojima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Miyake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai","family":"Noujima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Imai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soichiro","family":"Tani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiji","family":"Muramoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoharu","family":"Shimizu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuji","family":"Iwashita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaji","family":"Tani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,28]]},"reference":[{"issue":"Suppl A","key":"2302_CR1","doi-asserted-by":"publisher","first-page":"5A","DOI":"10.1155\/2005\/269076","volume":"19","author":"MS Silverberg","year":"2005","unstructured":"Silverberg MS, Satsangi J, Ahmad T, et al. 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