A 59-year-old man presented with a low grade fever for two weeks with abdominal pain, increasing fatigue, and drenching night sweats. Physical examination revealed no lymphadenopathy or hepatosplenomegaly. However, a computed tomography scan showed marked splenomegaly and diffuse abdominal adenopathy. Laboratory testing demonstrated pancytopenia and a highly elevated lactate dehydrogenase (1076 IU/l). Due to his critical condition, lymph node biopsy was not attempted and a bone marrow biopsy was performed instead. The biopsy showed multiple intertrabecular lymphoid aggregates, suspicious of lymphoma (Fig. 27.1). Subsequently, a right groin lymph node was biopsied (Fig. 27.2).


Chronic Lymphocytic Leukemia Hodgkin Lymphoma Mantle Cell Lymphoma Chronic Lymphocytic Leukemia Cell Elevated Lactate Dehydrogenase 
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  1. 1.
    Nakamura N, Abe M. Richter syndrome in B-cell chronic lymphocytic leukemia. Pathol Int 2003;53:195–203.CrossRefPubMedGoogle Scholar
  2. 2.
    Matolcsy A. High-grade transformation of low-grade non-Hodgkin lymphomas: mechanism of tumor progression. Leuk Lymphoma 1999;34:251–259.PubMedGoogle Scholar
  3. 3.
    Yee KWL, O’Brien SM, Giles FJ. Richter’s syndrome: Biology and therapy. Cancer J 2005;11:161–174.CrossRefPubMedGoogle Scholar
  4. 4.
    Ohno T, Smir BN, Weisenburger DD, et al. Origin of the Hodgkin/Reed-Sternberg cells in chronic lymphocytic leukemia with “Hodgkin’s transformation”. Blood 1998;91:1757–1761.PubMedGoogle Scholar
  5. 5.
    Brecher M, Banks PM. Hodgkin’s disease variant of Richter’s syndrome. Report of eight ases. Am J Clin Pathol 1990;90:333–339.Google Scholar
  6. 6.
    Fayad L, Robertson LE, O’Brien S, et al. Hodgkin’s disease variant of Richter’s syndrome: Experience at a single institution. Leuk Lymphoma 1996;23:333–337.CrossRefPubMedGoogle Scholar

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