Grey Zone Lymphoma, Diagnostic and Therapeutic Challenges: A Rare Case Report

Grey zone lymphoma (GZL) remains a challenging diagnosis because it has mixed features of diffuse large B cell lymphoma (DLBCL) and classic Hodgkin lymphoma (cHL). In this case report, we present a 69-year-old man who was diagnosed with GZL after an incidental finding of right axillary lymphadenopathy on Computed tomography (CT) scan during a recent hospitalization for an ischemic stroke. Excisional biopsy of the axillary node pathology was consistent with classic Hodgkin lymphoma (Nodular Sclerosing type). Subsequent Positron Emission Tomography (PET)/CT scan showed adenopathy above and below the diaphragm, as well as possible liver, bone, and colon disease. Liver biopsy revealed pathology consistent with DLBCL contrary to the Hodgkin disease seen on axillary biopsy resulting in an eventual diagnosis of GZL on further pathology review.