{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T07:06:02Z","timestamp":1768287962967,"version":"3.49.0"},"reference-count":14,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,11,17]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:p>Composite lymphoma is defined as two or more lymphomas with distinct morphological and immunophenotypical characteristics synchronously diagnosed at the same anatomical site. Composite lymphoma is rare, and the most common combination is follicular lymphoma (FL) associated with diffuse large B cell lymphoma, followed by FL associated with classic Hodgkin\u2019s lymphoma (HL). Histologically, composite lymphomas display a mixed pattern or distinct zonal distribution of each lymphoma component. Composite lymphoma poses a diagnostic challenge, especially when two lymphoma components are mixed in the same lymph node. Here, we report a case of composite HL and FL 11 years after initial and repeat biopsies consistent with FL in a man in his 70s emphasising the importance of repeat biopsy in lymphoma diagnosis.<\/jats:p>","DOI":"10.1136\/bcr-2022-254475","type":"journal-article","created":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T12:10:20Z","timestamp":1703765420000},"page":"e254475","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["An Atypical relapsing follicular lymphoma to composite Hodgkin\u2019s lymphoma"],"prefix":"10.1136","volume":"16","author":[{"given":"Sandra","family":"Abadir","sequence":"first","affiliation":[{"name":"Department of Hematology and Oncology, Cleveland Clinic Florida, Weston, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sindu","family":"Iska","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Cleveland Clinic Florida, Weston, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia Tse","family":"Bunting","sequence":"additional","affiliation":[{"name":"Department of Pathology, Cleveland Clinic Florida, Weston, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3664-3449","authenticated-orcid":false,"given":"Chieh-Lin","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Cleveland Clinic Florida, Weston, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,12,28]]},"reference":[{"key":"2025082710485527000_16.12.e254475.1","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1111\/ejh.13271","article-title":"Diagnosis and management of follicular lymphoma: a comprehensive review","volume":"103","author":"Dada","year":"2019","journal-title":"Eur J Haematol"},{"key":"2025082710485527000_16.12.e254475.2","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.annonc.2020.11.008","article-title":"Newly diagnosed and relapsed follicular lymphoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up","volume":"32","author":"Dreyling","year":"2021","journal-title":"Ann Oncol"},{"key":"2025082710485527000_16.12.e254475.3","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1002\/ajh.25696","article-title":"Follicular lymphoma: 2020 update on diagnosis and management","volume":"95","author":"Freedman","year":"2020","journal-title":"Am J Hematol"},{"key":"2025082710485527000_16.12.e254475.4","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/s00277-017-3151-2","article-title":"Transformed follicular lymphoma","volume":"97","author":"Fischer","year":"2018","journal-title":"Ann Hematol"},{"key":"2025082710485527000_16.12.e254475.5","first-page":"26","article-title":"ASH plenary study: for follicular lymphoma, use of rituximab in asymptomatic patients prolongs time to initial treatment\u2014but not survival","volume":"33","author":"Carlson","year":"2011","journal-title":"Oncology Times"},{"key":"2025082710485527000_16.12.e254475.6","doi-asserted-by":"publisher","DOI":"10.1080\/1042819032000159870"},{"key":"2025082710485527000_16.12.e254475.7","doi-asserted-by":"crossref","first-page":"3651","DOI":"10.21037\/apm-20-1290","article-title":"Composite lymphoma of Cervical lymph nodes with classical Hodgkin lymphoma and diffuse large B cell lymphoma: a case report and literature review","volume":"9","author":"Wang","year":"2020","journal-title":"Ann Palliat Med"},{"key":"2025082710485527000_16.12.e254475.8","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)70153-6"},{"key":"2025082710485527000_16.12.e254475.9","unstructured":"SEER*Explorer: an interactive Website for SEER cancer Statistics [SEER Incidence Data, November 2022 Submission (1975-2020), SEER 22 registries]. 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