Justin R. Yu , Qin Huang , Ping Hou , Jin-Ping Lai
{"title":"Collision tumor of colonic adenocarcinoma and EBV-driven large B-cell lymphoma: A case report and review of literature","authors":"Justin R. Yu , Qin Huang , Ping Hou , Jin-Ping Lai","doi":"10.1016/j.ctrc.2014.12.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Collision tumors of adenocarcinoma and lymphoma in the gastrointestinal tract are especially rare with few reported cases in literature. We report a unique case of a collision tumor and perform a literature review.</p></div><div><h3>Presentation of case</h3><p>An 86-year-old patient with a history of rheumatoid arthritis on chronic azathioprine and prednisone was found to have an invasive adenocarcinoma in the descending colon. A large atypical lymphocytic infiltrate was found at the base of this lesion, which demonstrated CD20, lambda and EBER positivity consistent with adenocarcinoma colliding with EBV-driven and lambda-restricted large B-cell lymphoma.</p></div><div><h3>Discussion</h3><p>With this report, there are now fifteen cases of this type of collision tumor although the true incidence may be higher. Our case is unique among previous reports as the collision developed within the setting of iatrogenic immunosuppression and tumor EBV positivity was demonstrated. The pathogenesis is unknown, and diagnosis requires a high-degree of suspicion.</p></div><div><h3>Conclusion</h3><p>It is important to consider immunosuppression in a patient with adenocarcinoma, as presence of atypical lymphoid cells may be indicative of lymphoma.</p></div>","PeriodicalId":90461,"journal":{"name":"Cancer treatment communications","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ctrc.2014.12.002","citationCount":"5","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer treatment communications","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2213089614000164","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 5
Abstract
Introduction
Collision tumors of adenocarcinoma and lymphoma in the gastrointestinal tract are especially rare with few reported cases in literature. We report a unique case of a collision tumor and perform a literature review.
Presentation of case
An 86-year-old patient with a history of rheumatoid arthritis on chronic azathioprine and prednisone was found to have an invasive adenocarcinoma in the descending colon. A large atypical lymphocytic infiltrate was found at the base of this lesion, which demonstrated CD20, lambda and EBER positivity consistent with adenocarcinoma colliding with EBV-driven and lambda-restricted large B-cell lymphoma.
Discussion
With this report, there are now fifteen cases of this type of collision tumor although the true incidence may be higher. Our case is unique among previous reports as the collision developed within the setting of iatrogenic immunosuppression and tumor EBV positivity was demonstrated. The pathogenesis is unknown, and diagnosis requires a high-degree of suspicion.
Conclusion
It is important to consider immunosuppression in a patient with adenocarcinoma, as presence of atypical lymphoid cells may be indicative of lymphoma.