Advanced Gastrointestinal Diffuse Large B-Cell Lymphoma Presenting with Obstructive Jaundice and Very High CA 19-9 Level Mimicking Pancreatic Adenocarcinoma

Adekolujo, Orimisan Samuel; Agu, Chidozie; Shamar, Iqbal; Trauber, David

doi:10.1007/s12029-015-9728-x

Cited by 3 publications

(5 citation statements)

References 17 publications

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“…27,28 Although there have been several reports of unusual gastrointestinal DLBCL NOS presentations, obstructive jaundice, and high CA 19-9 levels have never before been documented. 29 Abdominal pain, weight loss, and obstructive jaundice are frequently accompanied by elevated CA 19-9 levels in cases of advanced pancreatic carcinoma but not in cases of DLBCL NOS. 30 There was only one unusual case of advanced gastrointestinal DLBCL NOS, which had symptoms of obstructive jaundice and mimicked pancreatic adenocarcinoma by expressing extremely high levels of CA 19-9.…”

Section: Discussionmentioning

confidence: 97%

“…30 There was only one unusual case of advanced gastrointestinal DLBCL NOS, which had symptoms of obstructive jaundice and mimicked pancreatic adenocarcinoma by expressing extremely high levels of CA 19-9. 29 However, all prior research on gastrointestinal NHLs focused on serum levels of CA 19-9 rather than IHC expression made it necessary to investigate the actual rates of CA 19-9 protein expression in these tumors to understand the expected clinicopathological relationships. To our knowledge, neither the serum nor IHC expression levels of CA 19-9 in cases of nodal DLBCL NOS have been examined.…”

Section: Discussionmentioning

confidence: 99%

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Clinicopathological Characteristics and Prognosis of Diffuse Large B-Cell Lymphoma in Relation to CA-125 and CA 19-9 Expression

Foda,

Atia,

Sakr

et al. 2023

J Evid Based Complementary Altern Med

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Background: Some epithelial tumors express the carbohydrate antigen 125 (Cancer antigen-125, CA-125) and CA 19-9, especially ovarian and pancreatic tumors. Patients with non-Hodgkin lymphoma (NHL) were reported to have a close association between serum CA-125 levels and adverse prognostic factors with worse survival. We aimed to investigate CA-125 and 19-9 expression in nodal diffuse large B-cell lymphoma, not otherwise specified (DLBCL NOS) tissues using immunohistochemistry (IHC) and their relations to clinicopathological manifestations and patients' survival. Methods: 65 cases of DLBCL NOS were examined. A modified mechanical pencil tip was used to construct Manual Tissue Micro-array (TMA) blocks. Immunohistochemical staining for CA-125 and CA 19-9 was performed and scored semi-quantitatively. All relations were analyzed using established statistical methodologies. Results: Aberrant expression of CA 19-9 was detected in 12% of cases without any expression of CA-125. Moreover, 75% of the CA 19-9 positive cases were statistically significantly associated with anemia and performance status 1. Also, 75% of the CA 19-9 positive cases were females. Conclusions: CA 19-9 was aberrantly expressed in 12% of nodal DLBCL NOS cases and significantly related to anaemia and performance status but not to survival. In cases of DLBCL NOS, CA 19-9 expression cannot be considered an independent prognostic factor. CA-125 was not expressed in nodal DLBCL NOS tissues, necessitating re-evaluation studies. Therefore, it is advised to conduct more research to clarify the potential correlation between serum and tissue CA 19-9 levels and other clinic-pathological characteristics of nodal and extranodal DLBCL NOS patients.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Clinicopathological Characteristics and Prognosis of Diffuse Large B-Cell Lymphoma in Relation to CA-125 and CA 19-9 Expression

Foda,

Atia,

Sakr

et al. 2023

J Evid Based Complementary Altern Med

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“…This could probably be from compression on the bile duct, resulting in its luminal accumulation and reflux into the circulation. Although CA 19-9 is a well-known tumor marker of pancreatic adenocarcinoma, its high levels should not be misinterpreted, especially in the presence of obstructive jaundice [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

First Reported Case of Primary Intrahepatic Cholangiocarcinoma with Pure Squamous Cell Histology: A Case Report

et al. 2015

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Patient: Male, 64Final Diagnosis: Intrahepatic cholangiocarcinoma with pure squamous cellSymptoms: —Medication: —Clinical Procedure: —Specialty: —Objective:Rare diseaseBackground:In the United States, approximately 2500 cases of cholangiocarcinoma occur each year. The average incidence is 1 case/100 000 persons each year. Surgical resection is the mainstay for the treatment of cholangiocarcinoma. The result of surgery depends on location of the tumor, extent of tumor penetration of the bile duct, tumor-free resection margins, and lymph node and distant metastases. There has been an increase in the incidence of intrahepatic cholangiocarcinoma (IHCC) globally over a period of 30 years from 0.32/100 000 to 0.85/100 000 persons each year. Epidemiologically, the incidence of IHCC has been increasing in the U.S. from year 1973 to 2010.Case Report:We are reporting a first case of primary intrahepatic cholangiocarcinoma of pure squamous cell histology. A 64-year-old man presented with right upper-quadrant pain, jaundice, and weight loss. Imaging studies revealed a large hepatobiliary mass, intrahepatic bile duct dilation, normal common duct, and absence of choledocholithiasis. Delayed-contrast magnetic resonance imaging of the abdomen showed peripheral enhancement of the central lesion, which is typical of cholangiocarcinoma in contrast to hepatocellular carcinoma or metastasis. Cancer antigen 19-9 was markedly elevated. Liver function tests were deranged. Endoscopic retrograde cholangiopancreatography showed high degree of left hepatic duct stricture. Brush cytopathology was positive for atypia. The patient underwent exploratory laparotomy for en-bloc resection of the hepatobiliary mass with colon resection, liver resection, and cholecystectomy. Histology revealed keratinizing squamous cell carcinoma. Based on these findings, a definitive diagnosis of well-differentiated squamous cell carcinoma of the intrahepatic bile duct was made.Conclusions:Squamous cell carcinoma of the biliary tree is very rare and the majority of tumors are adenocarcinomas. Cholangiocarcinomas containing a squamous cell component have a poor prognosis due to its aggressive behavior. However, prognosis of cholangiocarcinoma with pure SCC histology is unknown because this is the first case in the literature.

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“…[2][3][4] CA 19-9 serum levels have been used for preoperative staging, assessment of resectability and prognosis of pancreato-biliary cancer, as well as diagnosis of tumour recurrence. [5][6][7][8][9] It may also increase in many benign conditions like cholangitis, choledocholithiasis, papillary stenosis etc., the diagnostic accuracy of such a marker is significantly reduced. 5,6 Thus, CA 19-9 has been used not only as a serum tumour marker for pancreatic and gastrointestinal carcinoma, but also to differentiate benign from malignant diseases of the pancreas.…”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7][8][9] It may also increase in many benign conditions like cholangitis, choledocholithiasis, papillary stenosis etc., the diagnostic accuracy of such a marker is significantly reduced. 5,6 Thus, CA 19-9 has been used not only as a serum tumour marker for pancreatic and gastrointestinal carcinoma, but also to differentiate benign from malignant diseases of the pancreas. [10][11][12][13] Biliary drainage includes ERCP (endoscopic retrograde cholangiopancreatography) sphincterotomy, stone/worm extraction, stent implantation or surgical intervention.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of Serum Carbohydrate Antigen 19-9 in Determining Etiology of Obstructive Jaundice

Bhuyian

Azam²,

Rob

et al. 2017

Birdem Med J

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Advanced Gastrointestinal Diffuse Large B-Cell Lymphoma Presenting with Obstructive Jaundice and Very High CA 19-9 Level Mimicking Pancreatic Adenocarcinoma

Cited by 3 publications

References 17 publications

Clinicopathological Characteristics and Prognosis of Diffuse Large B-Cell Lymphoma in Relation to CA-125 and CA 19-9 Expression

Clinicopathological Characteristics and Prognosis of Diffuse Large B-Cell Lymphoma in Relation to CA-125 and CA 19-9 Expression

First Reported Case of Primary Intrahepatic Cholangiocarcinoma with Pure Squamous Cell Histology: A Case Report

Diagnostic Accuracy of Serum Carbohydrate Antigen 19-9 in Determining Etiology of Obstructive Jaundice

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