A Lymphoma Almost Overlooked

Lorber, Jeremy; Zalom, Martina

doi:10.7759/cureus.2110

Cited by 2 publications

(3 citation statements)

References 6 publications

(6 reference statements)

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“…1). [12–262] The data were extracted from the abstract in 34 articles, [17,37–39,64,75,76,78,81,94,97,103,129,134,151,162,166,170,174,176,192,195,212,221,222,229,232,234,251,252,256,260–262] of which 21 were in English, 5 in Japanese, 3 in Spanish, 2 in French, 2 in Chinese, and 1 in Czech.…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2022

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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.

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Section: Resultsmentioning

confidence: 99%

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

et al. 2022

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“…Squamous cell carcinoma is the most common histological type, while primary lymphoma of the vagina is rare 7. DLBCL is the most common vaginal lymphoma while Burkitt’s lymphoma was even more rare 3 8–11. The reported age at presentation varies widely between 15 and 79 years.…”

Section: Discussionmentioning

confidence: 99%

“…The importance of biopsy for morphological assessment, immunohistochemical and cytogenetic analysis cannot be overemphasised as a mandatory step for accurate diagnosis and treatment 14. In some cases with absent B symptoms (fever, weight loss, drenching night sweats) and considering the rarity of vaginal lymphoma, initial imaging findings may be misdiagnosed as squamous cell carcinoma 10. Other differentials include adenocarcinoma, melanoma, sarcoma and carcinoid, and these are usually metastatic from regional structures such as the cervix, bladder, ovary, vulva, rectum or uterus 7.…”

Section: Discussionmentioning

confidence: 99%

Diffuse large B-cell lymphoma of the vagina in pregnancy

et al. 2020

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A 28-year-old primigravida was evaluated for complaints of difficulty urinating and pelvic pain of 6-weeks duration. She denied fever, night sweats, weight loss or fatigue. Pelvic ultrasonography revealed a single fetal pole with cardiac activity and a 7 cm mass in the anterior vagina which encased the urethra. The diagnosis of diffuse large B-cell lymphoma germinal centre type was made on analysis of biopsied pelvic mass. Whole body MRI revealed the disease was limited to the vagina. The patient received six cycles of Rituximab-cyclophosphamide, doxorubicin, vincristine and prednisone with significant improvement in her symptoms. Serial ultrasounds over the subsequent months showed appropriate development of the fetus. Whole body MRI after treatment showed decreased size and decreased signal of the primary pelvic mass compatible with favourable treatment response. Challenges in the management of this rare presentation of lymphoma are discussed.

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A Lymphoma Almost Overlooked

Cited by 2 publications

References 6 publications

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

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

Diffuse large B-cell lymphoma of the vagina in pregnancy

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