Synchronous laryngeal squamous cell carcinoma and Hodgkin lymphoma of the head and neck region

Integrative bioinformatics and machine learning identify key crosstalk genes and immune interactions in head and neck cancer and Hodgkin lymphoma

Head and neck squamous cell carcinoma (HNSCC) is a highly aggressive malignancy with complex molecular underpinnings. Hodgkin lymphoma (HL), another distinct cancer type, shares several biological characteristics with HNSCC, particularly regarding immune system involvement. However, the molecular crosstalk between HNSCC and HL remains largely unexplored. This study aims to elucidate shared molecular mechanisms, identify potential diagnostic biomarkers, and uncover therapeutic targets through an integrative approach combining bioinformatics and machine learning techniques. Publicly available RNA sequencing datasets were utilized to identify differentially expressed genes (DEGs) in HNSCC, while weighted gene co-expression network analysis (WGCNA) was applied to uncover HL-associated gene modules. The intersection of HNSCC DEGs and HL-related modules was evaluated using protein-protein interaction (PPI) network analysis. Candidate hub genes were selected via machine learning algorithms, including LASSO regression, random forest, and support vector machine-recursive feature elimination (SVM-RFE). Prognostic and diagnostic values were assessed using survival analysis and ROC curves. Furthermore, scRNA-seq data were analyzed to assess gene expression in the tumor microenvironment, and drug sensitivity was evaluated to identify potential therapeutic agents. A total of 150 shared genes were identified at the intersection of HNSCC DEGs and HL-associated gene modules. PPI network analysis highlighted 16 candidate hub genes, among which IL6, CXCL13, and PLAU were prioritized through machine learning methods. Survival analysis revealed that high expression of CXCL13 and PLAU, and low expression of IL6, were significantly associated with poor prognosis in HNSCC patients. ROC curve analysis validated their diagnostic performance. Single-cell RNA-seq data confirmed the expression of these biomarkers in macrophages, epithelial cells, and fibroblasts within the tumor microenvironment. Drug sensitivity analysis identified Andrographolide, Rituximab, and Amiloride as potential therapeutic agents. This study identified IL6, CXCL13, and PLAU as critical biomarkers involved in immune regulation and tumor progression in both HNSCC and HL. These findings provide valuable insights into the shared molecular mechanisms and suggest novel therapeutic strategies for patients affected by these diseases.

Coexistence of Hodgkin Lymphoma and Squamous Cell Carcinoma of the Tongue: A Case Report and Literature Review

We report an unusual case of a 39-year-old male patient with a previous history of treated classical Hodgkin lymphoma, presenting with tongue ulcer and left ear pain who was subsequently diagnosed with invasive squamous cell carcinoma of the oropharynx. This case highlights the importance of vigilance in patients with a history of lymphoma and the potential for the development of secondary malignancies. We discuss the clinical, radiological, and pathological findings and emphasize the need for close monitoring and early intervention in such cases.

Synchronous or collision solid neoplasms and lymphomas: A systematic review of 308 case reports

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.

Head and neck squamous cell cancer associated with lymphoproliferative malignancies is aggressive

BACKGROUND

Patients with non-Hodgkin's lymphoma and chronic lymphocytic leukaemia are at an elevated risk of further malignancy. Head and neck squamous cell carcinoma often presents with cervical lymph node metastasis, and can pose a diagnostic challenge in patients with non-Hodgkin's lymphoma or chronic lymphocytic leukaemia who may have pre-existing palpable neck nodes.

METHODS

A retrospective case review of a health board was conducted to identify patients with head and neck squamous cell carcinoma with a previous diagnosis of non-Hodgkin's lymphoma or chronic lymphocytic leukaemia.

RESULTS

Four patients with head and neck squamous cell carcinoma that developed after non-Hodgkin's lymphoma or chronic lymphocytic leukaemia were identified. Two patients had a background of non-Hodgkin's lymphoma treated with chemotherapy. The remaining two patients had a background of chronic lymphocytic leukaemia under active surveillance. Three out of the four patients died within 30 months of diagnosis.

CONCLUSION

Head and neck squamous cell carcinoma following non-Hodgkin's lymphoma or chronic lymphocytic leukaemia is aggressive. A heightened clinical suspicion is essential to facilitate early diagnosis and treatment of head and neck squamous cell carcinoma in patients with dual pathology.

Development of follicular lymphoma of the cervical lymph nodes in a postoperative patient with tongue cancer

Patients with head and neck squamous cell carcinoma are at an increased risk of developing second malignancies. Most commonly, these second primary malignancies are squamous cell carcinoma of the head and neck region, but also noted are esophageal cancer or lung cancer. Hematologic malignancies are uncommon second malignancies. Diagnosis can be challenging, particularly when a patient suffers metastases of squamous cell carcinoma to the cervical lymph nodes in addition to synchronous or metachronous malignant lymphoma that originates in the cervical lymph nodes. This article describes a case of primary follicular lymphoma in the cervical region that was discovered during a postoperative follow-up after partial glossectomy and neck dissection for tongue cancer.

Concomitant Hodgkin's lymphoma and gastric adenocarcinoma: a rare coincidence

Gastric adenocarcinomas may be seen together with colon, prostate, breast, liver, lung and gynecological malignancies as synchronous or metachronous cancer. However, Hodgkin's lymphoma (HL) is rarely diagnosed with solid tumors. Herein, a 72-year-old man with both gastric adenocarcinoma and HL has been presented. Mass lesions far away from the primary tumor in cancer patients can be not only the sign of distant metastasis but also another primary malignancy. In the English literature, synchronous gastric adenocarcinoma and HL has been rarely reported, and as far as we know, this is the third case to be reported.