Lolli E, Matteoni R, Barbieri A, D'Ambrosi M, Archontakis F
I Divisione di Chirurgia Generale, Ospedale S. Pertini, Roma.
Ann Ital Chir. 1998 Jan-Feb;69(1):101-4.
Some second malignant neoplasms are increasingly being observed following NHL and a considerable amount of data has accumulated in the literature. The authors describe a case of 65-year old male who presented with submandibular adenopathy. Results of a biopsy of the mass surgically removed revealed low grade non-Hodgkin lymphoma. During the staging workup, a meningioma and a renal cell adenocarcinoma (RCC) were unexpectedly discovered and successively resected. The patient is currently alive with no evidence of metastatic diseases 12 months after diagnosis of non-Hodgkin's lymphoma (NHL), 10 months after meningioma resection and 8 months after RCC resection. The possibility of an underlying pathologic mechanism predisposing to multiple tumours should be considered. RCC and central nervous system (CNS) neoplasms are among second malignancies with higher incidences in non-Hodgkin lymphoma patients whereas with specific regard to meningioma, one of the most common benign intracranial tumours that sometimes shows biological aggressiveness and malignancy, we have currently no data in the literature. Increased risks for several malignancies occur late in the NHL follow-up period and are largely confined to patients receiving either radiation therapy or chemotherapy. On the other hand, increased risks for renal cancer have also been reported at less than one year after diagnosis of NHL and are present in all treatment subgroups (radiation therapy, chemotherapy, other-no treatment). Increased risks for CNS malignant neoplasms have also been reported at less than one year. The authors review the pathogenic significance of this case report neoplasms association in the light of the various explicative hypothesis of this concurrence. Possible immune mechanisms associated with these neoplasm are particularly pointed up.
在非霍奇金淋巴瘤（NHL）之后，越来越多地观察到一些第二原发性恶性肿瘤，并且文献中已经积累了大量数据。作者描述了一例65岁男性患者，该患者表现为颌下腺病。手术切除肿块的活检结果显示为低级别非霍奇金淋巴瘤。在分期检查过程中，意外发现了一个脑膜瘤和一个肾细胞腺癌（RCC），并相继进行了切除。该患者在诊断非霍奇金淋巴瘤（NHL）后12个月、脑膜瘤切除术后10个月和肾细胞癌切除术后8个月时仍然存活，没有转移疾病的证据。应该考虑存在易患多种肿瘤的潜在病理机制的可能性。肾细胞癌和中枢神经系统（CNS）肿瘤是非霍奇金淋巴瘤患者中第二原发性恶性肿瘤发生率较高的类型，而关于脑膜瘤，它是最常见的良性颅内肿瘤之一，有时表现出生物学侵袭性和恶性，目前我们在文献中没有相关数据。几种恶性肿瘤的风险增加发生在NHL随访期的后期，并且主要局限于接受放射治疗或化疗的患者。另一方面，在诊断NHL后不到一年也报告了肾癌风险增加，并且在所有治疗亚组（放射治疗、化疗、其他 - 未治疗）中均存在。中枢神经系统恶性肿瘤的风险增加也在不到一年时被报告。作者根据这种并发情况的各种解释性假设，回顾了本病例报告中肿瘤关联的致病意义。特别指出了与这些肿瘤相关的可能免疫机制。
