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

Abstract

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.

A Rare Case of Synchronous Invasive Adenocarcinoma of the Colon and Marginal Zone Lymphoma of a Splenule Associated With Hemolytic Anemia

“…Hematologic and lymphatic malignancies make up 8.1% of cases [ 4 ]. The most commonly associated synchronous lymphoma with adenocarcinoma is Diffuse large B-cell lymphoma [ 5 ]. To our knowledge, our case is the first reported instance of invasive colonic adenocarcinoma with synchronous splenule MZL.…”

“…To our knowledge, our case is the first reported instance of invasive colonic adenocarcinoma with synchronous splenule MZL. There have been reports of a case involving rectal adenocarcinoma with splenic lymph node MZL [ 5 ].…”

“…The pathophysiologic mechanism underlying the synchronous development of solid tumors and lymphomas is unclear. Proposed mechanisms include obstructed lymphatic channels which may favor the development of solid tumors, suppression of lymphocytic apoptotic antitumor responses, and chronic inflammation generated by solid tumors triggering a lymphoma [ 5 ].…”

Oral squamous cell carcinoma with synchronous follicular lymphoma: A rare case report

“…In a systematic review by Parra-Medina et al of the clinicopathological characterization of more than 300 synchronous solid neoplasms and lymphomas, 98% of lymphomas were incidental findings and most commonly found in the locoregional lymph nodes; follicular lymphoma was one of the most prevalent types of synchronous lymphomas, as was the case with our patient. 19 In the head and neck area, the concept of cancerization after exposure to chronic carcinogens is widely accepted as a possible explanation for multiple HNSCCs; this is due to the fact that these anatomic locations are subject to similar contributing risk factors and a common clonal origin that is subject to identical genetic alterations. 20 Other contributing factors are smoking, genetic susceptibility, a deleterious lifestyle in an aging patient, and a cumulative amount of cytotoxic chemotherapy and radiation.…”

A Rare Occurrence of Solid Gynecological Malignancy Synchronous with Hematological Malignancy: Rare Case and Review of Literature

“…The most common location of primary solid malignancy associated with NHL is the gastrointestinal tract (esophagus to rectum), followed by the prostate, lung, and breast. 6 The synchronous association of solid tumors of ovary with hematological malignancy is one of the rarest forms of MPMs. In our case, diagnosis of DLBCL was made initially, while there was suspicion of second malignancy due positive ascitic fluid cytology for malignancy and borderline surface epithelium malignancy on tru-cut biopsy from adnexal mass.…”