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Sugaya R, Taniguchi A, Abe M, Ozawa I, Kirito K, Hatakeyama S. A Pancreatic Collision Tumor Comprising Mantle Cell Lymphoma and Adenocarcinoma: A Case Report and Literature Review. Intern Med 2024; 63:553-558. [PMID: 37380453 PMCID: PMC10937135 DOI: 10.2169/internalmedicine.1937-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/19/2023] [Indexed: 06/30/2023] Open
Abstract
A collision tumor is a rare clinical condition where two different tumors occur synchronically within a lesion. Pancreatic collision tumors with mantle cell lymphoma (MCL) are extremely rare and have only been reported in one case to date. We herein report an elderly patient with MCL and adenocarcinoma of the pancreas with Ann Arbor stage IV and Union for International Cancer Control stage IIB, respectively. The patient received palliative therapy and died 23 months after the diagnosis. Further research and case studies are required to investigate whether or not MCL-derived cyclin D1 overexpression affects the occurrence/growth of adenocarcinomas.
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Affiliation(s)
- Ryo Sugaya
- Department of Internal Medicine, Nikko City Hospital, Japan
- Division of General Internal Medicine, Jichi Medical University Hospital, Japan
| | - Ai Taniguchi
- Department of Internal Medicine, Nikko City Hospital, Japan
| | - Makoto Abe
- Department of Pathology, Tochigi Cancer Center, Japan
| | - Iwao Ozawa
- Department of Hepato-Biliary-Pancreatic Surgery, Tochigi Cancer Center, Japan
| | - Keita Kirito
- Department of Hematology and Oncology, University of Yamanashi, Japan
| | - Shuji Hatakeyama
- Division of General Internal Medicine, Jichi Medical University Hospital, Japan
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Jiang M, Yuan XP. Collision tumor of primary malignant lymphoma and adenocarcinoma in the colon diagnosed by molecular pathology: A case report and literature review. World J Clin Cases 2023; 11:6289-6297. [PMID: 37731579 PMCID: PMC10507543 DOI: 10.12998/wjcc.v11.i26.6289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/15/2023] [Accepted: 08/21/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Collision tumors of primary malignant lymphoma and adenocarcinoma in the colon are rare. Primary diffuse large B-cell lymphoma (DLBCL)-adenocarcinoma collision tumors are especially rare. CASE SUMMARY A 74-year-old woman presented with abdominal pain of 1 mo duration. Biopsy under colonoscopy revealed adenocarcinoma of the ascending colon. Subsequently, the patient underwent laparoscopic radical resection of right colon cancer with lymph node dissection. A collision tumor was found incidentally through postoperative pathological sampling. Genetic analysis showed a collision tumor of DLBCL with germinal center B-cell subtype and TP53 mutation, and adenocarcinoma arising in a tubulovillous adenoma in the colon, with BRAF mutation and mutL homolog 1 promoter methylation. The patient died 3 mo after surgery. To our knowledge, this is the 23rd reported case of collision tumor of colorectal adenocarcinoma and lymphoma. The mean age of the 23 patients was 73 years. The most common site was the cecum. There were 15 cases with follow-up data including 11 living and four dead with a 3-year overall survival rate of 71.5%. CONCLUSION Based on pathological and genetic analysis, surgery combined with chemotherapy or chemoradiotherapy may have good therapeutic effects for collision tumor.
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Affiliation(s)
- Meng Jiang
- School of Medicine, Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China
| | - Xiao-Ping Yuan
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China
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Vu KV, Trong NV, Khuyen NT, Huyen Nga D, Anh H, Tien Trung N, Trung Thong P, Minh Duc N. Synchronous rectal adenocarcinoma and intestinal mantle cell lymphoma: A case report. World J Clin Cases 2023; 11:5772-5779. [PMID: 37727717 PMCID: PMC10506007 DOI: 10.12998/wjcc.v11.i24.5772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/18/2023] [Accepted: 07/11/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Mantle cell lymphoma (MCL) of the gastrointestinal tract is a rare malignancy, accounting for about 0.2% of malignant colorectal tumors. MCL synchronous with rectal adenocarcinoma is extremely rare. We know of only a few cases reported in the literature. We describe the case of a patient with synchronous rectal adenocarcinoma and intestinal MCL. CASE SUMMARY A 63-year-old man was admitted to our hospital due to abdominal pain and hematochezia over the past month. The patient was diagnosed with middle rectal cancer cT2N0M0 and underwent surgery. However, we found a large tumor in the small intestine during surgery. The patient underwent total mesorectal excision for rectal cancer and resectioning of the ileal segment containing the large mass. Pathology and immunohistochemistry revealed the presence of both rectal adenocarcinoma and pathognomonic MCL stage IIE presenting as multiple lymphomatous polyposis. The patient subsequently underwent RDHAP/RCHOP chemotherapy and was maintained with rituximab. A Positron Emission Tomography and Computed Tomography (PET/CT) scan showed that the disease responded well to treatment without tumor-increased metabolism in the gastrointestinal tract. CONCLUSION Synchronous rectal adenocarcinoma and intestinal MCL presenting as multiple lymphomatous polyposis are extremely rare. MCL is often discovered fortuitously when rectal cancer is diagnosed. The coexistence of these tumors poses treatment challenges.
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Affiliation(s)
- Kim-Van Vu
- Department of General Surgery, Vietnam National Cancer Hospital, Ha Noi 100000, Viet Nam
- Department of Practical Surgery, Hanoi Medical University, Ha Noi 100000, Viet Nam
| | - Nguyen-Van Trong
- Department of Oncology, Hanoi Medical University, Ha Noi 100000, Viet Nam
| | - Nguyen-Thi Khuyen
- Pathology and Molecular Biology Center, Vietnam National Cancer Hospital, Ha Noi 100000, Viet Nam
| | - Do Huyen Nga
- Department of Hematologic Oncology, Vietnam National Cancer Hospital, Ha Noi 100000, Viet Nam
| | - Hoang Anh
- Department of General Surgery, Vietnam National Cancer Hospital, Ha Noi 100000, Viet Nam
- Department of Practical Surgery, Hanoi Medical University, Ha Noi 100000, Viet Nam
| | - Nguyen Tien Trung
- Department of General Surgery, Vietnam National Cancer Hospital, Ha Noi 100000, Viet Nam
| | - Pham Trung Thong
- Department of General Surgery, Vietnam National Cancer Hospital, Ha Noi 100000, Viet Nam
| | - Nguyen Minh Duc
- Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Viet Nam
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Saito M, Egami H, Kato T, Yokoyama E, Izumiyama K, Mori A, Morioka M, Kondo T, Tanei ZI. Synchronous colon cancer after treatment for rectal follicular lymphoma: A case report. Mol Clin Oncol 2022; 17:129. [PMID: 35832471 PMCID: PMC9264324 DOI: 10.3892/mco.2022.2562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/01/2022] [Indexed: 11/12/2022] Open
Abstract
Colorectal follicular lymphoma (FL) is rare. In addition, it is even rarer that colon cancer develops synchronously with colorectal lymphoma. The present study reports a case of sigmoid colon cancer that developed 6 months after endoscopic resection of rectal FL. A 71-year-old man with a history of developing mucosa-associated lymphoid tissue lymphoma in his stomach at age 48, right neck region at age 59 (the latter later modified as FL) and lung adenocarcinoma at age 60 now suffers from rectal FL. Endoscopic submucosal dissection (ESD) was performed at our hospital (Aiiku Hospital), and 6 months after the treatment, sigmoid colon cancer was confirmed by colonoscopy for the follow-up study. The patient was successfully curatively resected by ESD plus local resection and has survived without a recurrence for >3 years with no treatment. It was speculated that in the present case, cancer-related genes were changed as a carcinogenic mechanism due to decreased immune function associated with the onset of lymphoma.
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Affiliation(s)
- Makoto Saito
- Blood Disorders Center, Aiiku Hospital, Sapporo, Hokkaido 064-0804, Japan
| | - Hiroki Egami
- Department of Gastroenterology, Aiiku Hospital, Sapporo, Hokkaido 064-0804, Japan
| | - Takashi Kato
- Department of Gastroenterology, Aiiku Hospital, Sapporo, Hokkaido 064-0804, Japan
| | - Emi Yokoyama
- Blood Disorders Center, Aiiku Hospital, Sapporo, Hokkaido 064-0804, Japan
| | - Koh Izumiyama
- Blood Disorders Center, Aiiku Hospital, Sapporo, Hokkaido 064-0804, Japan
| | - Akio Mori
- Blood Disorders Center, Aiiku Hospital, Sapporo, Hokkaido 064-0804, Japan
| | - Masanobu Morioka
- Blood Disorders Center, Aiiku Hospital, Sapporo, Hokkaido 064-0804, Japan
| | - Takeshi Kondo
- Blood Disorders Center, Aiiku Hospital, Sapporo, Hokkaido 064-0804, Japan
| | - Zen-Ichi Tanei
- Department of Cancer Pathology, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido 060-8638, Japan
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Parra-Medina R, Rocha F, Castañeda-González JP, Moreno-Lucero P, Veloza L, Romero-Rojas AE. Synchronous or collision solid neoplasms and lymphomas: A systematic review of 308 case reports. Medicine (Baltimore) 2022; 101:e28988. [PMID: 35838994 PMCID: PMC11132339 DOI: 10.1097/md.0000000000028988] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/13/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The presence of a lymphoma associated with a solid synchronous neoplasm or collision neoplasm has been rarely in the literature, and a detailed characterization of these cases is lacking to date. OBJECTIVE To describe the main clinicopathological features of synchronous/collision tumors. METHODS A systematic search in PubMed, Scielo, and Virtual Health Library literature databases for cases or case series of synchronous or collision lymphoma and other solid neoplasms reported up to March 2021 was performed. Three reviewers independently screened the literature, extracted data, and assessed the quality of the included studies. The systematic review was performed following the Preferred Reporting Items for Systematic Meta-Analyses guidelines. RESULTS Mean age of patients was 62.9 years (52.9% men). A total of 308 cases were included (62% synchronous and 38% collision). The most frequent location of both synchronous and collision tumors was the gastrointestinal tract with the most common solid neoplasm being adenocarcinoma, and the most frequent lymphoma diffuse large B-cell lymphoma (21.7%) and mucosa-associated lymphoid tissue lymphoma (20.4%). Of the total number of mucosa-associated lymphoid tissue lymphomas and gastric adenocarcinomas, the presence of Helicobacter pylori infection was documented in 47.3% of them. Only 2% of all cases had a previous history of lymphoma. Thus, in most cases (98%), lymphoma was discovery incidentally. In addition, nodal lymphoma was associated with metastasis in 29 (9.4%) cases as collision tumor, most commonly (90%) in locoregional lymph nodes of the solid neoplasm. CONCLUSIONS The frequent association of some type of B-cell lymphoma and adenocarcinoma in synchronous/collision tumors of the gastrointestinal tract points to common pathogenic mechanisms in both neoplasia, particularly related to chronic inflammation in this location. In most cases, lymphoma identified in locoregional lymph nodes or distant of a carcinoma seems to represent an incidental finding during the carcinoma diagnostic/therapeutic approach. A synergy between carcinoma and lymphoma (involving inflammation and immunosuppression mechanisms) may favor tumor progression and dissemination. A better understating of the interactions lymphoma/carcinoma in the setting of synchronous/collision tumors may help to improve patient management and prognosis.
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Affiliation(s)
- Rafael Parra-Medina
- Department of Pathology, Fundación Universitaria de Ciencias de la Salud, Hospital San José, Bogotá, Colombia
- Research Institute, Fundación Universtaria de Ciencias de la Salud, Bogotá, Colombia
- Department of Pathology, Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Franky Rocha
- Department of Pathology, Fundación Universitaria de Ciencias de la Salud, Hospital San José, Bogotá, Colombia
| | | | - Paula Moreno-Lucero
- Department of Pathology, Fundación Universitaria de Ciencias de la Salud, Hospital San José, Bogotá, Colombia
| | - Luis Veloza
- Institute of Pathology, Lausanne University Hospital, Lausanne University, Lausanne, Switzerland
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Schep D, Van Koughnett JA, Velker V, Correa RJM. Synchronous colonic B cell lymphoma and adenocarcinoma in an elderly patient treated with R-mini-CHOP followed by resection. BMJ Case Rep 2022; 15:e236989. [PMID: 35508353 PMCID: PMC9073408 DOI: 10.1136/bcr-2020-236989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 12/09/2022] Open
Abstract
The simultaneous diagnosis of colonic lymphoma and adenocarcinoma in the same location is rare and presents challenges in its treatment considerations, especially in elderly patients. While previous cases have been described, there is little consistency in treatment regimens, and outcomes are generally poor. We describe the case of a man in his late 80s who presented with primary cecal and colonic B cell lymphoma, treated with R-mini-CHOP chemotherapy, but was found to have a residual adenocarcinoma in the cecum after treatment that was then successfully resected. The patient remains alive and well 3 years postoperation. This case highlights the need to consider lymphoma as a possible diagnosis for any colonic mass, and the need to consider rebiopsy of residual abnormal-appearing tissue postchemotherapy to confirm the diagnosis. Moreover, our report affirms that aggressive, curative-intent treatment with age-adjusted chemotherapy, and subsequent surgical resection is feasible for certain elderly patients with dual malignant diagnoses.
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Affiliation(s)
- Daniel Schep
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Julie Ann Van Koughnett
- London Health Sciences Centre, London, Ontario, Canada
- Divisions of General Surgery and Surgical Oncology, Western University, London, Ontario, Canada
| | - Vikram Velker
- London Health Sciences Centre, London, Ontario, Canada
- Division of Radiation Oncology, Western University, London, Ontario, Canada
| | - Rohann Jonathan Mark Correa
- London Health Sciences Centre, London, Ontario, Canada
- Division of Radiation Oncology, Western University, London, Ontario, Canada
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Ng HJ, Schmigylski R, Nale K, Collins P. Primary intestinal follicular lymphoma presenting as multiple lymphomatous polyposis. BMJ Case Rep 2020; 13:13/12/e238626. [PMID: 33318279 PMCID: PMC7737031 DOI: 10.1136/bcr-2020-238626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Multiple lymphomatous polyposis (MLP) is a rare condition, described in the literature as a presentation of extranodal mantle cell lymphoma. We report a rare case of follicular lymphoma presenting as MLP in a young woman with a short history of haematochezia who underwent colonoscopy. Immunohistochemistry on colonic biopsies confirmed follicular lymphoma. Microscopic examination found an extensive and dense lymphoid infiltrate, which demonstrated a follicular growth pattern. The neoplastic cells were positive with BCL2, BCL6, CD10 and CD20, and were negative with CD3, CD5, Cyclin D1 and SOX11. CT staging showed disseminated lymphadenopathy and the patient was commenced on chemotherapy. Endoscopic evaluation and histopathological analysis are vital for the accurate diagnosis of MLP. Our case demonstrates that follicular lymphoma should be considered as a differential, as not all cases of diffuse colonic MLP are related to mantle cell lymphoma. This distinction must be made to provide the best clinical management for the patient.
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Affiliation(s)
- Hwei Jene Ng
- Department of General Surgery, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Rudi Schmigylski
- Department of Pathology, Dumfries and Galloway Royal Infirmary, Dumfries, UK
| | - Krsty Nale
- Department of Pathology, Dumfries and Galloway Royal Infirmary, Dumfries, UK
| | - Patrick Collins
- General Surgery Department, Dumfries and Galloway Royal Infirmary, Dumfries, UK
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8
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Yu Q, Liu QY, Wei DM, Luo DZ. Metachronous Sigmoid Carcinoma and Mantle Cell Lymphoma in Intestines. Case Rep Gastroenterol 2019; 13:17-24. [PMID: 30792619 PMCID: PMC6381904 DOI: 10.1159/000495781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 11/20/2018] [Indexed: 01/17/2023] Open
Abstract
It is rare that colon carcinoma and mantle cell lymphoma (MCL) occur one after another in intestines. We found two malignancies of sigmoid carcinoma and MCL in a single patient, who had initially been diagnosed with sigmoid carcinoma and treated with radical resection in our hospital. Good postoperative recovery was reported without recurrence signs, which lasted for 7 years and 5 months until polyps of sigmoid colon were found by colonoscopy. Biopsy and immunohistochemistry revealed MCL, but the patient refused treatment. One year later, MCL was diagnosed again in the transverse colon. The patient is currently under observation and has not received treatment for MCL.
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Affiliation(s)
- Qiao Yu
- Department of Pathology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qiu-Yan Liu
- Department of Anesthesiology, the Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Dan-Ming Wei
- Department of Pathology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Dian-Zhong Luo
- Department of Pathology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
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9
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Metachronous colonic mantle cell lymphoma polyposis co-existing with metastatic appendiceal mucinous adenocarcinoma. HUMAN PATHOLOGY: CASE REPORTS 2017. [DOI: 10.1016/j.ehpc.2017.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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10
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Toh JWT, Raashed S, Kozman D. A rare case of diffuse pancolonic mantle cell lymphoma. Int J Colorectal Dis 2016; 31:713-4. [PMID: 25868515 DOI: 10.1007/s00384-015-2206-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/29/2015] [Indexed: 02/04/2023]
Affiliation(s)
- James Wei Tatt Toh
- Bankstown Hospital, Bankstown, Sydney, Australia. .,Liverpool Hospital, Cnr Goulburn and Elizabeth St., Liverpool, Sydney, Australia.
| | | | - Daniel Kozman
- Bankstown Hospital, Bankstown, Sydney, Australia. .,St. George Hospital, Kogarah, Sydney, Australia.
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Srikumar T, Markow M, Centeno B, Hoffe S, Tao J, Fernandez H, Strosberg J, Shibata D. Synchronous rectal adenocarcinoma and splenic marginal zone lymphoma. ACTA ACUST UNITED AC 2016; 23:e70-4. [PMID: 26966416 DOI: 10.3747/co.23.2711] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Synchronous cancers of different primary origin are rare. Here, we describe the case of a patient with concomitant diagnoses of rectal adenocarcinoma and splenic marginal zone lymphoma (smzl). A 57-year-old woman initially presented with abdominal pain. Physical examination and computed tomography demonstrated massive splenomegaly, and a complete blood count revealed microcytic anemia and lymphopenia. During the subsequent evaluation, she presented with hematochezia, melena, and constipation, which prompted gastroenterology referral. Subsequent endoscopic rectal ultrasonography revealed a T3N1 moderately differentiated rectal adenocarcinoma, with computed tomography imaging of chest, abdomen, and pelvis confirming no metastasis. Thus, the cancer was classified as clinical stage T3N1M0, stage iii. Bone marrow biopsy confirmed co-existing marginal zone lymphoma, and with the clinical presentation of massive splenomegaly, a diagnosis of smzl was made. The patient's management was individually tailored for simultaneous optimal treatment of both conditions. Concurrent treatment with neoadjuvant rituximab and 5-fluorouracil chemotherapy, with external-beam radiation therapy to the pelvis, was administered, followed by surgery consisting of en bloc splenectomy and distal pancreatectomy, and low anterior resection. The patient completed a standard course of adjuvant folfox (fluorouracil-leucovorin-oxaliplatin) chemotherapy and has remained disease-free for 7 years. To our knowledge, this report is the first to specifically describe simultaneous diagnoses of locally advanced rectal cancer and smzl. We also describe the successful combined neoadjuvant treatment combination of 5-fluorouracil, rituximab, and pelvic radiation.
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Affiliation(s)
- T Srikumar
- Morsani College of Medicine, University of South Florida, Tampa, FL, U.S.A.;; Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| | - M Markow
- Department of Pathology and Cell Biology, Morsani College of Medicine, University of South Florida, Tampa, FL, U.S.A.;; Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| | - B Centeno
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| | - S Hoffe
- Department of Radiation Oncology and Therapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| | - J Tao
- Department of Hematopathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| | - H Fernandez
- Department of Blood and Marrow Transplant, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| | - J Strosberg
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| | - D Shibata
- Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, U.S.A
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Braham E, Zarrouk M, Mlika M, Kilani T, El Mezni F. Synchronous mantle cell lymph node lymphoma and pulmonary adenocarcinoma: a case report with literature review. CLINICAL RESPIRATORY JOURNAL 2015; 11:430-432. [PMID: 26256690 DOI: 10.1111/crj.12352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 06/17/2015] [Accepted: 08/03/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Coexistence of mantle cell lymphoma and lung adenocarcinoma is extremely rare. The aim of this study is to present the first case of incidental discovery of primary lung adenocarcinoma associated to lymph node mantle cell lymphoma. METHODS A 45 year-old man, admitted for inguinal mass appeared since three months. Physical examination showed a 1 cm axillary and 3 cm inguinal adenopathies which were hard and fixed. A biopsy of inguinal mass revealed mantle cell lymphoma. Assessment of disease extension found a right superior lobe tumor with mediastinal lymphadenopathies. Fibreoptic bronchoscopy was normal. A fine needle biopsy of lung tumor was performed to determinate the nature of the pulmonary lesion. Histopathological findings were consistent with primary poor differentiated pulmonary adenocarcinoma with TTF-1 expression. A first mediastinoscopy was realized to verify mediastinal lymphadenopathies; frozen section showed a mantle cell lymphoma. A right lobectomy was then performed confirming the diagnosis of lung adenocarcinoma. Then, the patient was treated for the mantle cell lymphoma by 6 cures of alternating RCHOP and RDHAP (dexamethasone, high-dose Ara-Cytarabine and cisplatin) regimens followed by autologous stem cell transplantation. RESULTS The patient died because of treatment complications 3 years after diagnosis. CONCLUSION Progresses are necessary to understand the pathogenesis of of synchronous occurrence of both diseases.
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Affiliation(s)
- Emna Braham
- Department of Pathology, Abderrahmen Mami Hospital, Ariana, Tunisia
| | - Mourad Zarrouk
- Department of Pneumology, Abderrahmen Mami Hospital, Ariana, Tunisia
| | - Mouna Mlika
- Department of Pathology, Abderrahmen Mami Hospital, Ariana, Tunisia
| | - Tarek Kilani
- Department of Thoracic Surgery, Abderrahmen Mami Hospital, Ariana, Tunisia
| | - Faouzi El Mezni
- Department of Pathology, Abderrahmen Mami Hospital, Ariana, Tunisia
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13
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Yu JR, Huang Q, Hou P, Lai JP. Collision tumor of colonic adenocarcinoma and EBV-driven large B-cell lymphoma: A case report and review of literature. CANCER TREATMENT COMMUNICATIONS 2015; 3:7-12. [DOI: 10.1016/j.ctrc.2014.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Wang Z, Zhong M. Coexisting primary central nervous system non-Hodgkin's lymphoma and colorectal adenocarcinoma: A case report. Oncol Lett 2014; 7:994-996. [PMID: 24944656 PMCID: PMC3961312 DOI: 10.3892/ol.2014.1818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 10/18/2013] [Indexed: 12/03/2022] Open
Abstract
A 61-year-old female presented with night sweats following a resection for non-Hodgkin’s lymphoma of splenium corporis callosi. A positron emission tomography-computed tomography scan demonstrated that original lymphoma activity remained. A new ascending colon mass was identified simultaneously, which was diagnosed as an adenocarcinoma following the surgery. To the best of our knowledge, this is the first case to report a coexistence of primary central nervous system non-Hodgkin’s lymphoma and colorectal adenocarcinoma. The case poses a difficult clinical challenge.
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Affiliation(s)
- Zhengshi Wang
- Department of General Surgery, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai 200127, P.R. China
| | - Ming Zhong
- Department of General Surgery, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai 200127, P.R. China
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15
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Argyropoulos T, Foukas P, Kefala M, Xylardistos P, Papageorgiou S, Machairas N, Boltetsou E, Machairas A, Panayiotides IG. Simultaneous occurrence of colonic adenocarcinoma and MALT lymphoma: A series of three cases. World J Gastrointest Oncol 2012; 4:89-93. [PMID: 22532883 PMCID: PMC3334386 DOI: 10.4251/wjgo.v4.i4.89] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 01/14/2012] [Accepted: 01/25/2012] [Indexed: 02/05/2023] Open
Abstract
Simultaneous development of adenocarcinoma and primary B cell lymphoma of mucosa-associated lymphoid tissue (MALT) lymphoma of the colon is rare; only one case has so far been reported out of 13 cases with the coexistence of colonic adenocarcinoma with involvement of the colon by lymphoma. We hereby present three more cases, two females (aged 75 and 71 years) and a male (aged 72 years). All three underwent colectomy based on a preoperative biopsy revealing colonic carcinoma. Histological examination of the resection specimens disclosed a colonic adenocarcinoma in two cases, whereas a tubulovillous adenoma with superficial foci of intraepithelial adenocarcinoma was seen in the third case. Moreover, in all three cases, a coexisting MALT lymphoma was diagnosed in the colon (1 case), in both colon and adjacent lymph nodes (1 case) or in colonic lymph nodes and omentum (1 case). In the last case, a post-operative bone marrow biopsy revealed extensive infiltration of the bone marrow, due to which the patient received postoperative chemotherapy. Diagnostic and treatment issues are briefly discussed.
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Affiliation(s)
- Theodoros Argyropoulos
- Theodoros Argyropoulos, Periklis Foukas, Maria Kefala, Evmorfia Boltetsou, Ioannis G Panayiotides, 2nd Department of Pathology, University of Athens Medical School, "Attikon" University Hospital, Rimini1, GR-12464, Chaidari, Greece
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16
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Abstract
AIM To perform case series from one centre over 9 years, and review of the literature. The synchronous diagnosis of colorectal malignancy and lymphoma is rare. METHOD Case note review of patients identified from clinical databases. RESULTS Five patients were identified and findings discussed. In two patients colorectal malignancy staging CT scans identified pathological lymphadenopathy consistent with lymphoma. A further two patients had an incidental lymphoma on histological examination of the colorectal malignancy specimen. The fifth patient was found to have suspicious superior mesenteric lymph nodes at laparotomy. Histology confirmed two nodular lymphocyte-predominant Hodgkin's lymphomas, a lymphocytic-rich classical Hodgkin's lymphoma, a diffuse large B-cell lymphoma and a B-cell follicular lymphoma. CONCLUSION There is a need for vigilance for the possibility of dual pathologies in all specialties.
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Affiliation(s)
- L R Kidd
- Department of Colorectal Surgery, Singleton Hospital, Wales, UK.
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17
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Mantle cell lymphoma of the colon with massive splenomegaly: A case report. Arab J Gastroenterol 2011; 12:162-5. [DOI: 10.1016/j.ajg.2011.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2010] [Revised: 07/17/2010] [Accepted: 01/08/2011] [Indexed: 11/18/2022]
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18
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Sasaki S, Hatanaka K, Sahara N, Uekusa T, Hirayama K, Shirahata A, Ishimaru M. Collision tumor of primary malignant lymphoma and adenocarcinoma in the colon: report of a case. Surg Today 2010; 40:975-81. [PMID: 20872204 DOI: 10.1007/s00595-009-4166-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2009] [Accepted: 10/05/2009] [Indexed: 12/19/2022]
Abstract
This report presents the case of a 62-year-old man with a collision tumor of primary malignant lymphoma and adenocarcinoma in the cecum. All regional mesenteric lymph nodes that were removed surgically were found to be occupied by lymphoma cells and no lymph nodes contained any cancer cells, although the primary carcinomas did exhibit lymphatic invasion. Malignant lymphoma was also seen in the duodenum. Systemic chemotherapy was administered for the malignant lymphoma, and a complete response was thus obtained. However, just after chemotherapy multiple liver metastases of adenocarcinoma emerged, and chemotherapy against adenocarcinoma was therefore continued. The occurrence of synchronous lymphoma and adenocarcinoma of the colorectum is rare. Furthermore, collisions of these different entities are also extremely unusual; so far only five such case reports have been published. The accurate clinical determination of the dominant tumor and a close follow-up is required for proper treatment in these cases.
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Affiliation(s)
- Shin Sasaki
- Department of Surgery, Omori Red Cross Hospital, 4-30-11 Chuo, Ota-ku, Tokyo 143-8527, Japan
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19
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Sahasrabudhe N, Khirwadkar N, Prescott R. Synchronous adenocarcinoma and marginal zone B-cell lymphoma of the colon: a case report. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/j.mpdhp.2009.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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20
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Liao MT, Cheng MF, Chang WC, Wu YC, Lee HS, Tsai SH. Duodenal Mantle Cell Lymphoma in a Patient with Advanced Sigmoid Adenocarcinoma. South Med J 2009; 102:429-31. [DOI: 10.1097/smj.0b013e31819bc4b0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Sztarkier I, Levy I, Walfisch S, Delgado J, Benharroch D. Mantle cell lymphoma in a tubular adenoma: unusual presentation with synchronous colonic carcinoma. Ann Diagn Pathol 2009; 13:47-49. [PMID: 19118782 DOI: 10.1016/j.anndiagpath.2007.05.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
An 80-year-old man underwent sigmoidectomy for adenocarcinoma. Six months later, after a near-syncope incident, pancytopenia was detected in the absence of occult blood in the stools. A bone marrow biopsy showed malignant lymphoma, suggestive of mantle cell lymphoma (MCL). Colonoscopy at this time revealed 3 colonic tubular adenomas. Reassessment of the histology of the colonic polyps and appropriate immunohistochemical stains showed that the lamina propria of one of the tubular adenomas was infiltrated by MCL. Reexamination of the sections taken at the time of the original sigmoidectomy showed MCL in 2 of the regional lymph nodes removed at that time, but no evidence of lymphoma in the colon was found. To our knowledge, this is the fifth reported case of synchronous occurrence of intestinal MCL and colonic carcinoma and the first report of MCL presenting in a tubular adenoma of the colon.
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Affiliation(s)
- Ignacio Sztarkier
- Institute of Pathology, Soroka University Medical Center, Beer-Sheva, Israel
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22
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Hatzibougias D, Bobos M, Karayannopoulou G, Karkavelas G, Karapanagiotidis GT, Foroulis CN, Kostopoulos I. A rare tumoral combination, synchronous lung adenocarcinoma and mantle cell lymphoma of the pleura. World J Surg Oncol 2008; 6:137. [PMID: 19114021 PMCID: PMC2629472 DOI: 10.1186/1477-7819-6-137] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Accepted: 12/29/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Coexistence of adenocarcinoma and mantle cell lymphoma in the same or different anatomical sites is extremely rare. We present a case of incidental discovery of primary lung adenocarcinoma and mantle cell lymphoma involving the pleura, during an axillary thoracotomy performed for a benign condition. CASE PRESENTATION A 73-year old male underwent bullectomy and apical pleurectomy for persistent pneumothorax. A bulla of the lung apex was resected en bloc with a scar-like lesion of the lung, which was located in proximity with the bulla origin, by a wide wedge resection. Histologic examination of the stripped-off parietal pleura and of the bullectomy specimen revealed the synchronous occurrence of two distinct neoplasms, a lymphoma infiltrating the pleura and a primary, early lung adenocarcinoma. Immunohistochemical and fluorescence in situ hybridization assays were performed. The morphologic, immunophenotypic and genetic findings supported the diagnosis of primary lung adenocarcinoma (papillary subtype) coexisting with a non-Hodgkin, B-cell lineage, mantle cell lymphoma involving both, visceral and parietal pleura and without mediastinal lymph node involvement. The neoplastic lymphoid cells showed the characteristic immunophenotype of mantle cell lymphoma and the translocation t(11;14). The patient received 6 cycles of chemotherapy, while pulmonary function tests precluded further pulmonary parenchyma resection (lobectomy) for his adenocarcinoma. The patient is alive and without clinical and radiological findings of local recurrence or distant relapse from both tumors 14 months later. CONCLUSION This is the first reported case of a rare tumoral combination involving simultaneously lung and pleura, emphasizing at the incidental discovery of the two coexisting neoplasms during a procedure performed for a benign condition. Any tissue specimen resected during operations performed for non-tumoral conditions should be routinely sent for pathologic examination.
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Affiliation(s)
- Dimitrios Hatzibougias
- Aristotle University of Thessaloniki Medical School, AHEPA University Hospital, Department of Cardio-Thoracic Surgery, Thessaloniki, Greece.
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23
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Anavekar NS, Rozen WM, Rowe K, Murphy C. Synchronous carcinoma and lymphoma of the breast. Clin Breast Cancer 2008; 8:281-4. [PMID: 18650160 DOI: 10.3816/cbc.2008.n.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Primary breast lymphoma is a rare entity. Furthermore, extranodal marginal zone B-cell lymphoma affecting the breast is exceedingly rare. We report a unique case of invasive lobular carcinoma diagnosed simultaneously with an extranodal marginal zone B-cell lymphoma of the breast. A literature review demonstrated 2 reports of synchronous invasive ductal carcinoma and mucosa-associated lymphoid tissue lymphoma affecting the breast; however, there is a paucity of cases demonstrating different malignancies affecting the same breast tissue in a particular patient, especially in the setting of lobular carcinoma. As such, there are no clear guidelines on the optimal management of such synchronous tumors. Herein, the diagnostic and management issues are explored.
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24
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Chong Y, Shin JJ, Cho MY, Cui Y, Kim HY, Park KH. Synchronous primary gastric mantle cell lymphoma and early gastric carcinoma: a case report. Pathol Res Pract 2008; 204:407-11. [PMID: 18282664 DOI: 10.1016/j.prp.2007.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2007] [Revised: 11/28/2007] [Accepted: 12/11/2007] [Indexed: 10/22/2022]
Abstract
Mantle cell lymphoma (MCL) commonly invades the gastrointestinal (GI) tract. However, primary GI MCL is rare. We experienced a case of synchronous early gastric cancer (EGC) with primary gastric MCL found as a single early lesion rather than as multiple lymphomatous polyposis. An EGC was found in the cardia of a 64-year-old male on a routine GI endoscopic examination. A specimen obtained by total gastrectomy revealed another slightly elevated lesion in the pylorus. Microscopically, monotonous small- to medium-sized atypical lymphocytes with angulated nuclei formed a mass beneath the gastric mucosa. On immunohistochemical staining, the tumor cells revealed strong positivity for cyclin D1, positivity for both CD20 and bcl-2, and weak positivity for CD5, suggesting MCL. Clinically, there was no lymphoma in any other part of the body. This is the first case of an EGC accompanying a primary gastric MCL. Further investigation of a relationship between MCL and EGC and of factors that may affect GI involvement of MCL is necessary.
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Affiliation(s)
- Yosep Chong
- Department of Pathology, Yonsei University Wonju College of Medicine, #162 Ilsan-dong, Wonju, Gangwon-do, South Korea
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25
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Abstract
Synchronous occurrence of mantle cell lymphoma (MCL) and gastric cancer in the same patient has not yet been reported in the English literature. MCL comprises 2.5-7% of non-Hodgkin's lymphomas and is characterized by a poor prognosis with a median survival probability of 3-4 years in most series. A 62-year-old man was referred to our hospital for evaluation of an abnormal gastric lesion. The endoscopic finding was compatible with type IIc early gastric cancer (EGC) in the middle third of the stomach, and a biopsy of the lesion proved to be carcinoma. Radical total gastrectomy with splenectomy and Roux-en-Y esophagojejunostomy were performed. The resected specimen revealed two grossly separated lesions. Postoperative histological examination reported both adenocarcinoma and MCL. Immunohistochemical staining showed positivity for CD5, CD20, and cyclin D1 in the infiltrated lymphoid cells. MCL is an aggressive non-Hodgkin's lymphoma, and the current treatment approach is still unsatisfactory. Further advancements in the understanding of the synchronous occurrence of both diseases, and more efforts on investigations of treatment are needed.
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Affiliation(s)
- Yong Il Kim
- Department of Surgery, Ewha Womans University College of Medicine, 70 Chongro-6ga, Chongro-gu, Seoul 110-787, Korea.
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26
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Bhanote M, Choksi M, Cassar P, Edelman M, DellaRatta R, Staszewski H. Metastatic adenocarcinoma of the colon and follicular lymphoma within the same lymph node: a case report and review of the literature. ACTA ACUST UNITED AC 2006; 36:171-5. [PMID: 16720913 DOI: 10.1385/ijgc:36:3:171] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/1999] [Revised: 11/30/1999] [Accepted: 11/30/1999] [Indexed: 11/11/2022]
Abstract
Concomitant adenocarcinoma and non-Hodgkin's lymphoma, both located in the intestinal tract, are unusual. We report a unique case of moderately differentiated of the cecum and a simultaneous follicular lymphoma, Grade 1, of the terminal ileum and regional lymph nodes in a 55-yr-old man. One lymph node was involved by both adenocarcinoma and follicular lymphoma. To our knowledge, this is the fifteenth reported case of concurrent adenocarcinoma and non-Hodgkin's lymphoma of the intestine, but this is the first case with involvement of follicular lymphoma and adenocarcinoma within the same lymph node.
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Affiliation(s)
- Monisha Bhanote
- Department of Pathology, Oncology/Hematology Division, Winthrop University Hospital, Mineola, NY 11501, USA.
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27
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Pawarode A, Baer MR, Padmanabhan S, Wallace PK, Barcos M, Sait SNJ, Block AW, Wetzler M, Battiwalla M. Simultaneous presentation of acute monoblastic leukemia and mantle cell lymphoma: case report and review of the literature. Leuk Lymphoma 2005; 46:1813-8. [PMID: 16263586 DOI: 10.1080/10428190500244258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This paper reports a 73-year old woman with simultaneous presentation of acute monoblastic leukemia (acute myeloid leukemia (AML), French-American-British (FAB) type M5a) and mantle cell lymphoma. The patient presented with wasting, generalized lymphadenopathy, an extensive infiltrative rash and pancytopenia. Bone marrow and lymph node histopatholology showed extensive infiltration by leukemic monoblasts. Marrow cytogenetics revealed a complex karyotype, including t(8;16)(p11;p13). Flow cytometric immunophenotyping of peripheral blood, lymph node and bone marrow demonstrated two populations, expressing CD5, CD19, CD20 and CD22 and CD45, HLA-DR, CD13, CD33, CD14 and CD38, respectively. A focus of abnormal lymphocytes in the lymph node biopsy demonstrated BCL1 expression and t(11;14)(p11;p13) by fluorescence in situ hybridization and immunoglobulin heavy chain gene rearrangement by the polymerase chain reaction. The patient received infusional cytarabine, daunorubicin and etoposide chemotherapy, with complete remission of both the AML and the mantle cell leukemia. To the authors' knowledge, this is the first report of simultaneous presentations of AML, FAB M5a and mantle cell lymphoma. The case is discussed and the literature is reviewed.
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MESH Headings
- Aged
- Antigens, CD/blood
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biopsy
- Female
- Humans
- Leukemia, Monocytic, Acute/complications
- Leukemia, Monocytic, Acute/drug therapy
- Leukemia, Monocytic, Acute/pathology
- Lymphocytes/pathology
- Lymphoma, Mantle-Cell/complications
- Lymphoma, Mantle-Cell/drug therapy
- Lymphoma, Mantle-Cell/pathology
- Treatment Outcome
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Affiliation(s)
- A Pawarode
- Leukemia Section, Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York 14263, USA
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28
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Abstract
Synchronous colonic events are rare. Diverticulitis is the most common and lethal cause of colonic perforation. The first case in the literature of a synchronous diverticular perforation is presented. The patient was admitted with peritonitis. An exploratory laparotomy showed cecal and sigmoid perforations. Resection and primary anastomosis with a protective loop ileostomy was performed. Microscopic evaluation confirmed the presence of cecal and sigmoid perforated diverticuli. Diverticular disease is present in up to two-thirds of patients 80 years of age and older. Right-sided free colonic perforation is rare. Resection and primary anastomosis is feasible in the treatment of perforated diverticular disease. In this report, we emphasize the importance of a thorough abdominal exploration at the time of surgery.
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Affiliation(s)
- Eduardo Krajewski
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida
| | | | - Eric G. Weiss
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida
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29
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Abstract
Second malignancies occur with increased frequency in patients with chronic lymphocytic leukemia (CLL) regardless of treatment, but they may be more frequent and more aggressive after nucleoside analog therapy of CLL. In as many as 33% of patients with CLL who develop a second malignancy, a spontaneous remission of CLL precedes the diagnosis of the second malignancy by months or years. Richter's syndrome, whether manifested by anaplastic large cell lymphoma or Hodgkin's disease, is not truly a second malignancy because the CLL clone appears to be involved. However, all other malignancies developing in patients with CLL appear to be derived from a different clone. CLL and the second malignancy may have a common viral etiology. Second malignancies in patients with CLL should be treated as they would be in patients without CLL.
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Affiliation(s)
- Peter H Wiernik
- Our Lady of Mercy Cancer Center, 600 East 233rd Street, Bronx, NY 10466, USA.
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30
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Susnik B, Jordi Rowe J, Redlich PN, Chitambar C, Chang CC, Kampalath B. A Unique Collision Tumor in Breast. Arch Pathol Lab Med 2004; 128:99-101. [PMID: 14692838 DOI: 10.5858/2004-128-99-auctib] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
We report an extraordinary case of a collision tumor consisting of invasive ductal carcinoma with adjacent malignant lymphoma presenting as a single mass in the breast. A 79-year-old woman presented with a breast mass. A core biopsy performed at an outside hospital was interpreted as medullary carcinoma. On review of the breast core biopsy, a diagnosis of a synchronous malignant lymphoma and invasive ductal carcinoma was rendered. The patient underwent lumpectomy and axillary dissection. The excised specimen revealed a 2.1-cm, moderately differentiated invasive ductal carcinoma, partially surrounded by malignant lymphoma with areas where both tumors were intermixed. All 27 axillary lymph nodes were extensively involved by lymphoma, and 1 lymph node demonstrated metastatic carcinoma. The morphology and results of immunohistochemistry, flow cytometry, and cytogenetic analysis were consistent with extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue.
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Affiliation(s)
- Barbara Susnik
- Department of Pathology, Medical College of Wisconsin, Milwaukee 53226, USA.
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