A Rare Case of Mixed cellularity classic Hodgkin lymphoma with Positive CXCL13 Expression in Tumor Cells

Background Mixed cellularity classic Hodgkin lymphoma is quite common among the subtypes of Hodgkin lymphoma. In cases of this disease, the structure of the affected lymph nodes often shows varying degrees of damage. Early - stage lesions mostly manifest as involvement of the interfollicular area, partial lymph node involvement, and follicular atrophy. In this article, we report a specific case of Mixed cellularity classic Hodgkin lymphoma and review the literature related to this condition. Case presentation A 29-year-old male presented with fever and left lower abdominal pain. Upon physical examination, multiple swollen lymph nodes could be touched in his left lower abdomen. To make a clear diagnosis, a biopsy was performed on the relevant site. Through comprehensive immunohistochemical analysis and the results of bone marrow smear, the patient was diagnosed with Hodgkin's lymphoma (Mixed cellularity type). After the diagnosis, chemotherapy was carried out for him immediately according to the ABVD protocol. It is worth emphasizing that the prominent feature of this case is the positive expression of CXCL13 in tumor cells. Generally, CXCL13 is only expressed in helper T cells. However, in this case, the appearance of CXCL13 expression in the patient's tumor cells is extremely unusual. After an in-depth and comprehensive search of previous literature, no similar reports have been found. This is undoubtedly an extremely rare situation in the relevant research field and also provides new focuses and exploration directions for subsequent research work. Conclusion This case demonstrates the typical characteristics of Mixed cellularity classic Hodgkin lymphoma. Notably, the tumor cells show positive CXCL13 expression. Although the existing research on this phenomenon is relatively limited, based on current understanding, it is speculated that there may be a common precursor lesion between this situation and angioimmunoblastic T - cell lymphoma. This finding not only deepens our understanding of Mixed cellularity classic Hodgkin lymphoma but also alerts us that once positive CXCL13 expression in tumor cells is detected, the potential possibility of this disease should be taken into consideration.