我们报告了一名 72 岁男性的序列性淋巴瘤的独特病例，最初诊断为 Epstein-Barr 病毒 (EBV) 阳性直肠经典霍奇金淋巴瘤 (cHL)，随后发展为弥漫性大 B 细胞淋巴瘤 (DLBCL)在肺里。这种罕见的进展强调了与 EBV 感染相关的淋巴瘤的复杂性及其不可预测的临床过程。患者的旅程始于顽固性腹泻、食欲不振和体重显着减轻的症状，最终被诊断为 4B 期 cHL，最初采用布伦妥昔单抗/多柔比星、长春花碱、达卡巴嗪 (AVD) 化疗进行治疗。尽管有部分缓解，但监测发现患者已转变为 DLBCL，其特点是出现新的肺部病变。该病例强调了治疗序贯性淋巴瘤的临床和诊断挑战，强调了 EBV 在淋巴瘤发生中的作用以及从常见前体细胞进行克隆进化的潜力。治疗方法从靶向化疗发展到考虑自体干细胞移植和嵌合抗原受体（CAR）T细胞治疗等先进治疗，反映了该疾病的侵袭性和不良预后。该病例有助于我们了解 EBV 对淋巴瘤进展的影响，并强调在类似的临床情况下需要警惕监测和适应性治疗策略。版权所有 © 2024，Di 等人。

We report a distinctive case of sequential lymphomas in a 72-year-old male, initially diagnosed with Epstein-Barr virus (EBV)-positive rectal classic Hodgkin lymphoma (cHL), followed by the development of diffuse large B cell lymphoma (DLBCL) in the lung. This rare progression underscores the complexity of lymphomas associated with EBV infection and their unpredictable clinical courses. The patient's journey began with symptoms of intractable diarrhea, low appetite, and significant weight loss, leading to the diagnosis of stage 4B cHL, managed initially with brentuximab/doxorubicin, vinblastine, dacarbazine (AVD) chemotherapy. Despite a partial response, surveillance identified a transition to DLBCL, marked by new pulmonary lesions. This case highlights the clinical and diagnostic challenges in managing sequential lymphomas, emphasizing the role of EBV in lymphomagenesis and the potential for clonal evolution from a common precursor cell. The therapeutic approach evolved from targeted chemotherapy to consideration of advanced treatments such as autologous stem cell transplant and chimeric antigen receptor (CAR) T-cell therapy, reflecting the aggressive nature and poor prognosis of the disease. This case contributes to our understanding of the EBV's impact on lymphoma progression and underscores the need for vigilant monitoring and adaptive treatment strategies in similar clinical scenarios.Copyright © 2024, Di et al.