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同步性淋巴瘤与消化系统癌的诊断和治疗:4例报告及文献复习

Diagnosis and Treatment of Synchronous Lymphoma and Digestive System Carcinoma: Report of Four Cases and Literature Review.

作者信息

Meng Jingshu, Pan Huaxiong, Li Xiaoqian, Liu Tao, Liu Zijian, Li Qiuhui, Xiao Yin, Liu Xinxiu, Wu Gang, Zhu Fang, Zhang Liling

机构信息

Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Front Oncol. 2019 Dec 10;9:1367. doi: 10.3389/fonc.2019.01367. eCollection 2019.

Abstract

To investigate the diagnosis and treatment of synchronous lymphoma and digestive system carcinoma and review literature. We retrospectively analyzed the clinical data of four cases of synchronous lymphoma and digestive system carcinoma treated at our hospital. The clinical manifestations, pathological results, and treatment strategies were investigated. One of the four cases was diagnosed as follicular lymphoma with gastric adenocarcinoma, and the other three were diagnosed as diffuse large B-cell lymphoma with digestive system adenocarcinoma in the liver, sigmoid colon, and duodenum papilla, respectively. The second carcinoma was initially discovered incidentally because of the stage examination of lymphoma or the patient's poor response to treatment. The diagnosis of synchronous lymphoma and digestive system carcinoma depended mainly on the pathological examination. The accurate diagnosis of synchronous malignancies is challenging because they rarely occur. We suggest a scrupulous re-biopsy of extranodal lesions in patients with lymphoma to improve the diagnostic accuracy of related double primary tumors. Age, performance status, symptoms, pathological types, and tumor staging should be considered when formulating a treatment strategy. The systemic treatment regimens should include drugs targeting the synchronous tumors in question, and these remain to be explored further.

摘要

探讨同步性淋巴瘤与消化系统癌的诊断及治疗并复习文献。我们回顾性分析了我院收治的4例同步性淋巴瘤与消化系统癌患者的临床资料。对其临床表现、病理结果及治疗策略进行了研究。4例患者中,1例诊断为滤泡性淋巴瘤合并胃腺癌,另外3例分别诊断为弥漫性大B细胞淋巴瘤合并肝脏、乙状结肠及十二指肠乳头消化系统腺癌。第二原发癌最初是因淋巴瘤分期检查或患者对治疗反应不佳而偶然发现的。同步性淋巴瘤与消化系统癌的诊断主要依赖病理检查。同步性恶性肿瘤的准确诊断具有挑战性,因为其很少发生。我们建议对淋巴瘤患者的结外病变进行细致的再次活检,以提高相关双原发肿瘤的诊断准确性。制定治疗策略时应考虑年龄、体能状态、症状、病理类型及肿瘤分期。全身治疗方案应包括针对相关同步性肿瘤的药物,而这仍有待进一步探索。

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