Non-hodgkin lymphoma and pleural mesothelioma in a person exposed to asbestos

Abstract

Non-Hodgkin lymphoma and pleural mesothelioma may co-exist in the same patient. A large cell non-Hodgkin lymphoma of the inguinal lymph nodes was diagnosed in a 73-year-old woman. The patient was treated by chemotherapy. She did not receive radiotherapy. The patient had been exposed to asbestos having worked in a cotton mill and in a distillery. Four years after the diagnosis of lymphoma, she presented with a left pleural effusion. Large biopsies of the pleura showed a malignant mesothelioma, biphasic type, and pleural plaques. Epidemiological studies about the asbestos-lymphoma relationship gave conflicting results. The lymphoma-mesothelioma association is not exceptional, and suggests that asbestos plays a role in the etiology of both malignancies.

Are there still other asbestos-related malignancies to be discovered?

“…To the best of our knowledge, there are only two other cases of asbestos exposure and mycosis fungoides association reported in the literature. The ones reported in US by Chirinos and Geskin developed mesothelioma [14]. In our patient, asbestosis and mycosis fungoides were diagnosed on the first admission, but we don't have a clear documentation if one preceded the other.…”

“…Over the last decades, there were studies suggesting a causal relation between asbestos exposure and the development of lympho-proliferative disorders [13] and a study published in USA highlighted development of mycosis fungoides' in two patients with prolonged exposure to asbestos [14]. We report the case of a patient with a 30 years history of occupational exposure to asbestos fibers who developed mycosis fungoides.…”

A case of multiple primary malignancies including peritoneal mesothelioma surviving over 11 years

“…The particular combination of cancers should be examined in an attempt to explain the occurrence through the elucidation of a common risk factor or perhaps genetic predisposition; regarding the relationship between asbestos exposure and tumors of the hematopoietic system, we should know that development of NHL and asbestos‐related mesothelioma in the same patient has repeatedly been observed 15‐17 . A small study has also supported an association between occupational exposure to asbestos and colon cancer incidence in men 18 . Our patient had neither prior history of asbestos exposure (as a probable common risk factor of mesothelioma, lymphoma, and rectal adenocarcinoma) nor abdominal radiation, but the genetic study was not accomplished.…”

“…[15][16][17] A small study has also supported an association between occupational exposure to asbestos and colon cancer incidence in men. 18 Our patient had neither prior history of asbestos exposure (as a probable common risk factor of mesothelioma, lymphoma, and rectal adenocarcinoma) nor abdominal radiation, but the genetic study was not accomplished. A study conducted in 2018 by Hung et al on 88 patients with peritoneal mesothelioma showed that 13% of patients are anaplastic lymphoma kinase (ALK) positive by immunohistochemistry and in three out of eleven patients; ALK rearrangement was detected by fluorescence in situ hybridization (FISH) as well.…”