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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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Kataoka J, Nitta T, Ota M, Fujii K, Ishii M, Senpuku S, Ueda Y, Tsuchimoto Y, Takeshita A, Miyatake J, Ishibashi T. Collision Tumor Comprising Primary Malignant Lymphoma and Adenocarcinoma in the Ascending Colon. Case Rep Gastroenterol 2021; 15:379-388. [PMID: 33976615 PMCID: PMC8077522 DOI: 10.1159/000513972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 12/11/2020] [Indexed: 12/18/2022] Open
Abstract
We describe the case of a 78-year-old man with collision tumor from the primary malignant lymphoma and adenocarcinoma in the ascending colon. He suffered anemia from sigmoid colon cancer, and colonoscopy revealed early-stage colorectal cancer with a diameter of 20 mm in the cecum, the biopsy specimen showed moderately differentiated adenocarcinoma. Contrast-enhanced computed tomography (CT) revealed bowel wall thickening with contrast enhancement at the cecum; however, no lymph node and organ metastases were found. As above, we performed laparoscopic ileocecal resection with D3 lymph node dissection. The postoperative course was uneventful, and he was discharged from the hospital on postoperative day 11. Histopathological findings were moderately differentiated adenocarcinoma which invaded the muscularis propria and serosa from the submucosa, while the adjacent serosa showed a highly diffuse proliferation of atypical cells with an irregular nuclear-to-cytoplasmic ratio. Besides, immunohistochemical staining findings were diffuse large B-cell lymphoma, and diffuse large B-cell lymphoma was coexistent with moderately differentiated adenocarcinoma. We treated the patient with cyclophosphamide, doxorubicin, vincristine, and prednisolone in combination with rituximab (R-CHOP therapy) during 3 months postoperatively. When the 8 courses had been completed, postoperative positron emission tomography-CT (PET-CT) confirmed complete response, and the disease control has been doing well. Malignant lymphoma of the colorectal region is relative rare, and the occurrence of synchronous lymphoma and adenocarcinoma of the colon is also rare. Furthermore, collision tumor by these different entities is very unusual. We presented here such a case. 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)
- Jun Kataoka
- Department of Surgery, Gastroenterological Center, Shunjukai Shiroyama Hospital, Osaka, Japan
| | - Toshikatsu Nitta
- Department of Surgery, Gastroenterological Center, Shunjukai Shiroyama Hospital, Osaka, Japan
| | - Masato Ota
- Department of Surgery, Gastroenterological Center, Shunjukai Shiroyama Hospital, Osaka, Japan
| | - Kensuke Fujii
- Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, Osaka, Japan
| | - Masatsugu Ishii
- Department of Surgery, Gastroenterological Center, Shunjukai Shiroyama Hospital, Osaka, Japan
| | - Sadakatasu Senpuku
- Department of Surgery, Gastroenterological Center, Shunjukai Shiroyama Hospital, Osaka, Japan
| | - Yasuhiko Ueda
- Department of Surgery, Gastroenterological Center, Shunjukai Shiroyama Hospital, Osaka, Japan
| | - Yusuke Tsuchimoto
- Department of Internal Medicine, Gastroenterological Center, Shunjukai Shiroyama Hospital, Osaka, Japan
| | - Atsushi Takeshita
- Department of Pathology, Osaka Medical College Hospital, Osaka, Japan
| | - Junichi Miyatake
- Department of Hematology, Shunjukai Shiroyama Hospital, Osaka, Japan
| | - Takashi Ishibashi
- Department of Surgery, Gastroenterological Center, Shunjukai Shiroyama Hospital, Osaka, Japan
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