Dłuski Dominik, Lewkowicz Dorota, Leszczyńska-Gorzelak Bożena, Obrzut Bogdan, Rechberger Tomasz, Semczuk Andrzej
Department of Obstetrics and Perinatology, Lublin Medical University, Lublin, Poland.
Department of Pathology, Lublin Medical University, Lublin, Poland.
Case Rep Oncol. 2018 May 31;11(2):347-352. doi: 10.1159/000489662. eCollection 2018 May-Aug.
The coexistence of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) with different gynecologic neoplasms is a rare phenomenon. Here, we report a case of simultaneously developed CLL/SLL with endometrioid-type uterine cancer.
A 58-year-old woman was admitted to the 2nd Department of Gynecology, Lublin Medical University, Lublin, Poland, in June 2017, where the uterine cancer was diagnosed. After the surgery, pathological examination revealed a uterine moderately differentiated adenocarcinoma of endometrioid subtype (subtype I according to Bokhman) deeply infiltrating the myometrium as well as the uterine cervix. Surprisingly, CLL/SLL was subsequently diagnosed in all removed pelvic as well as para-aortic lymph nodes. Immunohistochemical analysis showed CD45 (++), CD20 (+), CD3 (-/+), CD19 (+), CD23 (+), CD5 (+), and CD34 (+). Proliferative activity, assessed by MIB-1 proliferative index immunostaining, reached 18%. The patient was admitted to radiotherapy and chemotherapy at the Oncology Hospital, Lublin, Poland, and is still on follow-up.
The coexistence of CLL/SLL with various gynecological malignancies, especially primary human endometrial cancer, is a rare entity. The detection of both tumors simultaneously, in general, is accidental, and the management should not be different from the situation in which malignancy appears de novo.
慢性淋巴细胞白血病/小淋巴细胞淋巴瘤(CLL/SLL)与不同妇科肿瘤并存是一种罕见现象。在此,我们报告一例同时发生CLL/SLL和子宫内膜样型子宫癌的病例。
一名58岁女性于2017年6月入住波兰卢布林医科大学第二妇科,在该科室被诊断出患有子宫癌。手术后,病理检查显示为子宫内膜样亚型(根据博赫曼分类为I型)的子宫中度分化腺癌,深度浸润肌层及宫颈。令人惊讶的是,随后在所有切除的盆腔及腹主动脉旁淋巴结中均诊断出CLL/SLL。免疫组化分析显示CD45(++)、CD20(+)、CD3(-/+)、CD19(+)、CD23(+)、CD5(+)和CD34(+)。通过MIB-1增殖指数免疫染色评估的增殖活性达到18%。该患者在波兰卢布林肿瘤医院接受了放疗和化疗,目前仍在随访中。
CLL/SLL与各种妇科恶性肿瘤,尤其是原发性人类子宫内膜癌并存是一种罕见情况。一般来说,同时检测到这两种肿瘤是偶然的,其治疗管理应与新发恶性肿瘤的情况无异。