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Berti PP, Pirillo V, Rizzo P, Ria A, Mannelli F, Broger M. Collision tumor between a spinal schwannoma and chronic lymphocytic leukemia/small lymphocytic lymphoma: case report and review of the literature. Br J Neurosurg 2023; 37:1266-1268. [PMID: 33249871 DOI: 10.1080/02688697.2020.1849549] [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] [Received: 07/28/2020] [Accepted: 11/06/2020] [Indexed: 10/22/2022]
Abstract
A collision tumor is one where two neoplasms of differing type occur at the same anatomical site. We present a patient suffering from non Hodgkin small cell lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) and complaining intense lumbar back pain refractory to medical treatment. Lumbosacral MRI showed an intradural extramedullary lesion in the left L2-L3 foramen with extracanalar development and compression of psoas muscle. CT showed intralesional calcification. The patient underwent resection of the lesion through a paraspinal posterolateral approach (Wiltse approach). The histology was of schwannoma with intralesional calcifications and lymphocitic infiltrates compatible with B-lineage SLL/CLL. After the operation the patient suffer from left psoas muscle motor weakness (3/5 MRC). Because of hematological disease progression, she underwent 6 cycles of chemioterapy (Fludarabine, Cyclophosphamide, Rituximab). At a six-month follow-up no recurrence or residual tumor upon lumbosacral MR imaging was detectable and the left thigh flexion returned normal. To our knowledge, this is the first described case in the literature of collision tumor between a solitary spinal Schwannoma and SLL/CLL.
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MESH Headings
- Female
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/complications
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/surgery
- Lymphoma, Non-Hodgkin
- Rituximab/therapeutic use
- Cyclophosphamide
- Neurilemmoma
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Affiliation(s)
- Pier Paolo Berti
- Department of Neurosurgery, University of Verona, Civile Maggiore Hospital, Verona, Italy
| | - Vania Pirillo
- Department of Neurosurgery, S. Maurizio Hospital, Bolzano, Italy
| | - Paolo Rizzo
- Department of Neurosurgery, S. Maurizio Hospital, Bolzano, Italy
| | - Antonio Ria
- Department of Neurosurgery, S. Maurizio Hospital, Bolzano, Italy
| | - Francesco Mannelli
- Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Chen X, Chen J, Liao S, Cao Y. Invasive ductal carcinoma and small lymphocytic lymphoma/chronic lymphocytic leukemia manifesting as a collision breast tumor: A case report and literature review. Open Life Sci 2021; 16:867-871. [PMID: 34522780 PMCID: PMC8402943 DOI: 10.1515/biol-2021-0093] [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: 05/18/2021] [Revised: 07/11/2021] [Accepted: 07/21/2021] [Indexed: 11/17/2022] Open
Abstract
Collision breast tumors, consisting of breast cancer (BC) and non-Hodgkin’s lymphoma (NHL), are extremely rare. Here we report the case of a 64-year-old woman with a collision tumor in her left breast mass that was composed of invasive ductal carcinoma and small lymphocytic lymphoma/chronic lymphocytic leukemia. In addition, we reviewed the published comparable English-language literature. Collision breast tumor composed of BC and NHL is extremely rare. For that reason, there is a lack of consensus about the underlying mechanism, and diagnosing it without delay remains a complex clinical challenge. We found that post-menopausal, age-related estrogen levels changes and Epstein-Barr virus infection are possible pathogenic factors. However, the symptoms are almost identical, and it is difficult to distinguish a simple breast tumor from a breast collision tumor. In this study, we reviewed the clinical features of all patients with BC and NHL colliding breast tumors; this information might enable early identification and prevention of misdiagnosis.
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Affiliation(s)
- Xiaowen Chen
- Department of Oncology Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Jianli Chen
- The Third Department of Medical Oncology, The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - Sihai Liao
- Department of Oncology Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Yuwen Cao
- Department of Pathology, Shihezi University School of Medicine, Shihezi, Xinjiang, China
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Pizzi M, Sbaraglia M, Bellan A, Santoro L, Dal Santo L, De Bartolo D, Carraro E, Zoletto S, Visentin A, Marino D, Trentin L, Dei Tos AP. Incidental lymphomas in surgical pathology: diagnostic clues and clinical-pathological correlations. Virchows Arch 2021; 480:459-465. [PMID: 33830333 DOI: 10.1007/s00428-021-03096-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/21/2021] [Accepted: 03/30/2021] [Indexed: 11/30/2022]
Abstract
Incidental lymphomas (ILs) are rare and challenging lesions with poorly characterized clinical-epidemiological and histological features. The present study addressed the open issues concerning these tumors, by assessing the clinical-pathological features of 28 consecutive ILs, diagnosed over a 10-year period at a tertiary center for surgical pathology. ILs were more frequently documented in elderly males (mean age at surgery 70.8 years; M/F ratio 3.3), with sharp prevalence of gastrointestinal and urinary tract involvement (22/28 [78.6%] cases). Low-grade B-cell lymphomas outnumbered all other entities, and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) was the most common subtype (18/28 [64.3%] cases). Compared to other ILs, CLL/SLL occurred at older age and was the sole lymphoid neoplasm affecting the urinary tract. In conclusion, ILs are rare lesions, mostly affecting the gastrointestinal and urinary tract of elderly males. The diagnosis of IL is based on a high degree of suspicion and on careful morphological/phenotypic characterization.
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Affiliation(s)
- Marco Pizzi
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy.
| | - Marta Sbaraglia
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy
| | - Alberto Bellan
- Department of Pathology, ULSS6, Camposampiero Hospital, Camposampiero - Padua, Italy
| | - Luisa Santoro
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy
| | - Luca Dal Santo
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy
| | - Debora De Bartolo
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy
| | - Elisa Carraro
- Oncohematology Unit, Department of Children and Women's Health, University of Padua, Padua, Italy
| | - Simone Zoletto
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy
| | - Andrea Visentin
- Hematology & Clinical Immunology Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy
| | - Dario Marino
- Medical Oncology 1, Veneto Institute of Oncology IOV IRCCS, Padua, Italy
| | - Livio Trentin
- Hematology & Clinical Immunology Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy
| | - Angelo Paolo Dei Tos
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy
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Lin YS, Hamilton AER, Henderson C, Farzin M. Tiny but Mighty: Collision Tumor of a Superficial Adenocarcinoma Arising From a Tubulovillous Adenoma with Associated Low-Grade Follicular Lymphoma. Int J Surg Pathol 2021; 29:759-763. [PMID: 33619998 DOI: 10.1177/1066896921995942] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Collision tumors are rare and there have only been a few previously described cases between an intestinal adenoma and a lymphoma. We report the first case of a 74-year-old woman who on investigation for iron deficiency had a tubulovillous adenoma with underlying follicular lymphoma. The atypical lymphoid proliferation showed immunohistochemical positivity for cluster of differentiation 20 (CD20), B-cell lymphoma 2 (BCL2), and B-cell lymphoma 6 (BCL6). Subsequent right hemicolectomy showed a superficially invasive adenocarcinoma.
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Affiliation(s)
- Yee Sing Lin
- 34378Liverpool Hospital, Liverpool, Australia.,67422Western Sydney University, Campbelltown, Australia
| | - Auerilius E R Hamilton
- 63608Campbelltown Hospital, Campbelltown, Australia.,7800University of New South Wales, South Western Sydney Clinical School, Liverpool, Australia
| | - Christopher Henderson
- 34378Liverpool Hospital, Liverpool, Australia.,67422Western Sydney University, Campbelltown, Australia
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The first case of a collision tumor of gastrointestinal stromal tumor and intravascular large B cell lymphoma. Ann Hematol 2021; 101:233-235. [PMID: 33459824 DOI: 10.1007/s00277-021-04418-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
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Lolli G, Broccoli A, Stefoni V, Argnani L, Leone O, Cavo M, Zinzani PL. Chronic lymphocytic leukemia focus in the context of a cardiac mass in a pretreated patient: an exceptional incidental finding. TUMORI JOURNAL 2020; 106:NP29-NP32. [PMID: 32162585 DOI: 10.1177/0300891620909421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND B-cell chronic lymphocytic leukemia (B-CLL) is a lymphoproliferative disorder consisting of clonal proliferation and accumulation of small, mature, CD5-positive B-lymphocytes in the blood, bone marrow, and lymphoid tissues. Among extranodal localizations, cardiac involvement is extremely rare: to our knowledge, there are no findings reported in the literature of concomitant B-CLL diagnosis in the context of atrial myxoma (so-called collision tumours) and the best strategy to treat these malignancies is unclear. CASE REPORT We report the case of a 67-year-old woman diagnosed with B-CLL and atrial myxoma. Our patient was cardiologically symptomless and the cardiac mass was an incidental finding. The cardiac tumor appeared several years after B-CLL diagnosis. Histologic examination of the cardiac mass, removed in the suspicion of an atrial myxoma, revealed a lymphoid focus of B-CLL. The patient underwent surgery and subsequent systemic therapy for B-CLL. CONCLUSIONS The concomitant presence of B-CLL in the context of an atrial myxoma is extremely rare. The best strategy to treat these cardiac hematologic malignancies is unclear.
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Affiliation(s)
- Ginevra Lolli
- Institute of Haematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy
| | - Alessandro Broccoli
- Institute of Haematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy
| | - Vittorio Stefoni
- Institute of Haematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy
| | - Lisa Argnani
- Institute of Haematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy
| | - Ornella Leone
- Pathological Anatomy and Histology, AOU Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Michele Cavo
- Institute of Haematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy
| | - Pier Luigi Zinzani
- Institute of Haematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy
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