Sequential occurrence of diffuse large B-cell lymphoma and carcinoma in the nasopharynx

Abstract

Background:The sequential occurrence of the 2 malignancies development of nasopharyngeal carcinoma (NPC) and lymphoma is extremely rare and their coexistence raises the question of a common etiologic factor.Clinical findings/clinical concerns:A 71-year-old previously healthy man presented with diffuse large B-cell lymphoma (BCL) followed by NPC almost 2 years later with Epstein–Barr virus (EBV) positive.Diagnosis:Endoscopic examination characterized a fixed, hard and nontender mass in the nasopharynx and biopsies were done.Intervention:A patient successfully underwent chemotherapy for lymphoma and chemoradiation for carcinoma sequentially.Outcomes:He was followed up every 3 months for 1 year with endoscopic and radiological examinations. The nasopharynx mass was completely resolved after chemoradiation therapy.Conclusion:The presentation with diffuse large B-cell lymphoma (BCL) and NPC in this patient was perhaps caused by dual EBV infection or a different oncogenic mechanism.

Characterization and Establishment of a Novel EBV Strain Simultaneously Associated With Nasopharyngeal Carcinoma and B-Cell Lymphoma

“…Indeed, one of the most enigmatic aspect of EBV has been the epidemiological phenomenon that although it homogenously infects human adult populations from all geographic regions, the incidence of neoplastic diseases which it spawns is extremely skewed (2,3). Another phenomenon widely appreciated by clinicians is the fact that EBV-associated NPC and lymphomas of the head and neck region rarely ever afflict the same individual, with no more than five case reports in the literature documenting the synchronous or sequential diagnosis of both types of neoplasms (36,(47)(48)(49). In the only case report in which viral genotyping was performed, it was revealed that the patient's (Hodgkin) lymphoma and NPC were driven by distinct EBV strains (36).…”

Characterization and establishment of a novel EBV strain simultaneously associated with nasopharyngeal carcinoma and B-cell lymphoma

“…Indeed, one of the most enigmatic aspect of EBV has been the epidemiological phenomenon that although it homogenously infects human adult populations from all geographic regions, the incidence of neoplastic diseases which it spawns is extremely skewed [2,3]. Another phenomenon widely appreciated by clinicians is the fact that EBV-associated NPC and lymphomas of the head and neck region rarely ever afflict the same individual, with no more than five case reports in the literature documenting the synchronous or sequential diagnosis of both types of neoplasms [28,42–44]. In the only case report in which viral genotyping was performed, it was revealed that the patient’s (Hodgkin) lymphoma and NPC were driven by distinct EBV strains[28].…”