Carcinoma and multiple lymphomas in one patient: establishing the diagnoses and analyzing risk factors |
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Authors: | Elisa Cannizzo Aliyah R Sohani Judith A Ferry Ephraim P Hochberg Michael J Kluk Michelle E Dorn Craig Sadowski Janessa J Bucci Adam M Ackerman Janina A Longtine Giovanni Carulli and Frederic I Preffer |
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Institution: | 1Division of Hematology, Department of Oncology, Transplants and New Technologies in Medicine, University of Pisa, Pisa, Italy ;2Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA USA ;3MGH Cancer Center, Massachusetts General Hospital, Boston, MA USA ;4Department of Pathology, Brigham and Women’s Hospital, Boston, MA USA |
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Abstract: | Multiple malignancies may occur in the same patient, and a few reports describe cases with multiple hematologic and non-hematologic neoplasms. We report the case of a patient who showed the sequential occurrence of four different lymphoid neoplasms together with a squamous cell carcinoma of the lung. A 62-year-old man with adenopathy was admitted to the hospital, and lymph node biopsy was positive for low-grade follicular lymphoma. He achieved a partial remission with chemotherapy. Two years later, a PET-CT scan showed a left hilar mass in the lung; biopsy showed a squamous cell carcinoma. Simultaneously, he was diagnosed with diffuse large B cell lymphoma in a neck lymph node; after chemo- and radiotherapy, he achieved a complete response. A restaging PET-CT scan 2 years later revealed a retroperitoneal nodule, and biopsy again showed a low-grade follicular lymphoma, while a biopsy of a cutaneous scalp lesion showed a CD30-positive peripheral T cell lymphoma. After some months, a liver biopsy and a right cervical lymph node biopsy showed a CD30-positive peripheral T cell lymphoma consistent with anaplastic lymphoma kinase-negative anaplastic large cell lymphoma. Flow cytometry and cytogenetic and molecular genetic analysis performed at diagnosis and during the patient’s follow-up confirmed the presence of two clonally distinct B cell lymphomas, while the two T cell neoplasms were confirmed to be clonally related. We discuss the relationship between multiple neoplasms occurring in the same patient and the various possible risk factors involved in their development. |
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Keywords: | Diffuse large B cell lymphoma Follicular lymphoma Anaplastic large cell lymphoma Risk factors Multiple malignancies Cytogenetics |
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