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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: 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: 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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Ojima T, Tabata H, Yamaue H. Laparoscopic distal gastrectomy for synchronous adenocarcinoma, diffuse large B cell lymphoma and gastrointestinal stromal tumor in the stomach: a case report. Surg Case Rep 2022; 8:89. [PMID: 35526194 PMCID: PMC9081074 DOI: 10.1186/s40792-022-01446-1] [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: 01/12/2022] [Accepted: 05/05/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Synchronous lymphoma and adenocarcinoma are occasionally detected in the stomach. Gastrointestinal stromal tumor (GIST) and adenocarcinoma are sometimes seen simultaneously in the stomach. However, we rarely observe synchronous adenocarcinoma, lymphoma, and GIST in the stomach, and there are few reports on cases with these three lesions. CASE PRESENTATION This is a case report of a 71-year-old man who had a laparoscopic distal gastrectomy and lymphadenectomy for three gastric tumors. Preoperative diagnoses were early adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma in the stomach, but final diagnosis was synchronous adenocarcinoma, diffuse large B cell lymphoma (DLBCL), and GIST. Helicobacter pylori (H. pylori) is highly involved in the development of DLBCL and MALT lymphoma in the stomach. Gastric adenocarcinoma is partially involved in chronic gastritis with atrophy and intestinal metaplasia caused by H. pylori infection. Indeed, a rapid urease test was found positive in this case. Therefore, we prescribed medicine to eliminate H. pylori after gastrectomy. CONCLUSION This is the first case report where a patient underwent minimally invasive laparoscopic gastrectomy for synchronous adenocarcinoma, DLBCL and GIST in the stomach, although one patient who underwent open gastrectomy for synchronous adenocarcinoma, MALT lymphoma and GIST was previously reported.
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Affiliation(s)
- Toshiyasu Ojima
- Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan.
| | - Hirotaka Tabata
- Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan
| | - Hiroki Yamaue
- Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan
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Miyazaki R, Arihiro S, Hayashi E, Kitahara T, Oki S, Kamba S, Ide D, Komoike N, Satoh K, Kato T, Saruta M, Tajiri H, Aoki H, Omura N, Mitsumori N, Mitsuishi T, Yanagisawa H, Takahashi H. A Giant Gastrointestinal Stromal Tumor of the Stomach with Extramural Growth. Case Rep Gastroenterol 2016; 10:344-351. [PMID: 27920639 PMCID: PMC5121561 DOI: 10.1159/000447291] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 05/31/2016] [Indexed: 01/21/2023] Open
Abstract
A 76-year-old man presented to our hospital with abdominal distention and loss of appetite. The 10% of weight lost relative to this patient in 1 month. Abdominal computed tomography and magnetic resonance imaging revealed a giant mass, with a major axis of 23 cm, containing solid components, not involving the upper abdominal organs. Esophagogastroduodenoscopy showed extramural compression from the middle gastric body to the antrum, as well as a normal mucosal surface. These findings were suggestive of a gastrointestinal stromal tumor attached to the anterior wall of the stomach without metastasis or invasion. Partial gastrectomy was performed for tumor resection, and the patient was subsequently treated with adjuvant imatinib. We report a rare case of a large extramural gastrointestinal stromal tumor of the stomach that was larger than 20 cm in diameter and present a pertinent literature review.
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Affiliation(s)
- Ryosuke Miyazaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Seiji Arihiro
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Eri Hayashi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Takuya Kitahara
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Sayumi Oki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Syunsuke Kamba
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Daisuke Ide
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Nobuhiko Komoike
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Kenichi Satoh
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Tomohiro Kato
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Masayuki Saruta
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Hiroaki Aoki
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Nobuo Omura
- Division of Gastrointestinal Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Norio Mitsumori
- Division of Gastrointestinal Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Takehiro Mitsuishi
- Department of Pathology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Haruka Yanagisawa
- Department of Pathology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Hiroyuki Takahashi
- Department of Pathology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
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Takahashi T, Maruyama Y, Saitoh M, Itoh H, Yoshimoto M, Tsujisaki M, Nakayama M. Synchronous Occurrence of Diffuse Large B-cell Lymphoma of the Duodenum and Gastrointestinal Stromal Tumor of the Ileum in a Patient with Immune Thrombocytopenic Purpura. Intern Med 2016; 55:2951-2956. [PMID: 27746431 PMCID: PMC5109561 DOI: 10.2169/internalmedicine.55.6712] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
A 64 year-old woman with steroid-dependent immune thrombocytopenia developed anemia. Esophagogastroduodenoscopy revealed the presence of a tumor, which was diagnosed to be diffuse large B-cell lymphoma, in the second portion of the duodenum. 18F-fluorodeoxy glucose positron emission tomography showed an increased uptake mass in the pelvic cavity as well as in the duodenum. Though the duodenal tumor disappeared after 4 cycles of chemotherapy, the pelvic mass did not shrink in size. As a result, laparoscopic resection of the pelvic tumor was performed and the tumor was histologically diagnosed to be a gastrointestinal stromal tumor. Subsequently, the patient was treated with 2 more cycles of the chemotherapy. Eventually, thrombocytopenia completely resolved.
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MESH Headings
- Antineoplastic Combined Chemotherapy Protocols
- Duodenal Neoplasms/complications
- Duodenal Neoplasms/pathology
- Duodenal Neoplasms/therapy
- Duodenum/pathology
- Endoscopy, Digestive System
- Female
- Gastrointestinal Stromal Tumors/complications
- Gastrointestinal Stromal Tumors/pathology
- Gastrointestinal Stromal Tumors/therapy
- Humans
- Ileum/pathology
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Middle Aged
- Purpura, Thrombocytopenic, Idiopathic/complications
- Purpura, Thrombocytopenic, Idiopathic/pathology
- Purpura, Thrombocytopenic, Idiopathic/therapy
- Tomography, X-Ray Computed
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Rodríguez-González D, Delgado-Plasencia L, Hernández-León C, Torres-Monzón E, Castro-Peraza ME, Cruz-Jurado J, Bravo-Gutiérrez A, Medina-Arana V. [C-KIT in gastrointestinal stromal tumors and associated malignancies: A Study in a population with genetic isolation]. GASTROENTEROLOGIA Y HEPATOLOGIA 2015; 38:484-90. [PMID: 25843813 DOI: 10.1016/j.gastrohep.2015.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 02/05/2015] [Accepted: 02/05/2015] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract. Numerous studies have reported the association between GIST and other neoplasms. OBJECTIVES The aim of this study was to investigate the possible association between GIST and other tumors in a genetically isolated population. METHODS A retrospective study was conducted of patients with GIST between 2002 and 2009 at our center. Epidemiological, pathological and family data in patients with GIST alone (group A) were compared with those in patients with GIST associated with other neoplasms (group B). A possible common genetic mechanism was investigated between GIST and associated malignancies by testing the detection of the immunohistochemical marker, CD117, in all tumors. RESULTS Twenty-two patients with GIST were identified, 10 in group A (45%) and 12 in group B (55%). In group B, the associated tumor was malignant in 6 patients (50%) and benign in another 6 (50%). Of the 22 patients with GIST, 8 (36%) had a family history of malignancies. Of these 8 patients, 7 (87.5%) were in group B (p=0.03) and 3 (37.5%) showed the same pathological type of neoplasm as their relatives. All GIST were positive for CD117 whereas associated malignancies were negative for this marker. CONCLUSION We did not find immunohistochemical positivity for CD117 in malignancies associated with GIST. Given the special characteristics of the study population, the association between GIST and associated malignancies may be incidental.
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Affiliation(s)
- Diana Rodríguez-González
- Servicio de Cirugía General y Digestiva, Hospital Universitario de Canarias, Santa Cruz de Tenerife, España
| | - Luciano Delgado-Plasencia
- Servicio de Cirugía General y Digestiva, Hospital Universitario de Canarias, Santa Cruz de Tenerife, España.
| | - Carmen Hernández-León
- Servicio de Anatomía Patológica, Hospital Universitario de Canarias, Santa Cruz de Tenerife, España
| | - Esther Torres-Monzón
- Servicio de Radiología, Hospital Universitario de Canarias, Santa Cruz de Tenerife, España
| | - María Elisa Castro-Peraza
- Servicio de Cirugía General y Digestiva, Hospital Universitario de Canarias, Santa Cruz de Tenerife, España
| | - Josefina Cruz-Jurado
- Servicio de Oncología Médica, Hospital Universitario de Canarias, La Cuesta, Santa Cruz de Tenerife, España
| | - Alberto Bravo-Gutiérrez
- Servicio de Cirugía General y Digestiva, Hospital Universitario de Canarias, Santa Cruz de Tenerife, España
| | - Vicente Medina-Arana
- Servicio de Cirugía General y Digestiva, Hospital Universitario de Canarias, Santa Cruz de Tenerife, España
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Tokunaga M, Ohyama S, Fujimoto Y, Hiki N, Fukunaga T, Yamamoto N, Yamaguchi T. Simultaneous adenocarcinoma and leiomyoma of the stomach presenting as a collision tumor. Clin J Gastroenterol 2009; 2:394-397. [PMID: 26192793 DOI: 10.1007/s12328-009-0109-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2009] [Accepted: 09/07/2009] [Indexed: 12/16/2022]
Abstract
A 68-year old Japanese man was referred to the Cancer Institute Hospital for the treatment of a rectal cancer. Preoperative esophagogastroduodenoscopy revealed a submucosal tumor with ulcer formation near the esophagogastric junction of the stomach. The initial treatment strategy was to perform a proximal gastrectomy with limited lymph node dissection as well as a simultaneous anterior resection. However, histopathological examination of a biopsy specimen of the submucosal tumor revealed a moderately differentiated adenocarcinoma, and therefore a total gastrectomy with D2 lymph node dissection was performed. Histopathological examination of the resected specimen revealed both adenocarcinoma and leiomyoma presenting as a collision tumor. Preoperative accurate histopathological diagnosis of a gastric submucosal tumor is generally difficult. Consequently, surgical resection of large gastric submucosal tumors may be indicated in the absence of histopathological confirmation of the diagnosis. However, in this case preoperative histopathological diagnosis enabled surgeons to perform the appropriate surgery. We conclude that to determine the appropriate treatment strategy, preoperative histopathological examination of tumors should be performed even in a case of suspected submucosal tumor, particularly if mucosal ulceration is present.
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Affiliation(s)
- Masanori Tokunaga
- Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Shigekazu Ohyama
- Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - Yoshiya Fujimoto
- Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Naoki Hiki
- Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Tetsu Fukunaga
- Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Noriko Yamamoto
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Toshiharu Yamaguchi
- Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan
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