Jiang Meng, Yuan Xiao-Ping
School of Medicine, Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China.
Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China.
World J Clin Cases. 2023 Sep 16;11(26):6289-6297. doi: 10.12998/wjcc.v11.i26.6289.
Collision tumors of primary malignant lymphoma and adenocarcinoma in the colon are rare. Primary diffuse large B-cell lymphoma (DLBCL)-adenocarcinoma collision tumors are especially rare.
A 74-year-old woman presented with abdominal pain of 1 mo duration. Biopsy under colonoscopy revealed adenocarcinoma of the ascending colon. Subsequently, the patient underwent laparoscopic radical resection of right colon cancer with lymph node dissection. A collision tumor was found incidentally through postoperative pathological sampling. Genetic analysis showed a collision tumor of DLBCL with germinal center B-cell subtype and mutation, and adenocarcinoma arising in a tubulovillous adenoma in the colon, with mutation and promoter methylation. The patient died 3 mo after surgery. To our knowledge, this is the 23 reported case of collision tumor of colorectal adenocarcinoma and lymphoma. The mean age of the 23 patients was 73 years. The most common site was the cecum. There were 15 cases with follow-up data including 11 living and four dead with a 3-year overall survival rate of 71.5%.
Based on pathological and genetic analysis, surgery combined with chemotherapy or chemoradiotherapy may have good therapeutic effects for collision tumor.
结肠原发性恶性淋巴瘤与腺癌的碰撞瘤罕见。原发性弥漫性大B细胞淋巴瘤(DLBCL)-腺癌碰撞瘤尤为罕见。
一名74岁女性,腹痛1个月。结肠镜检查活检显示升结肠腺癌。随后,患者接受了腹腔镜右半结肠癌根治术并清扫淋巴结。术后病理采样偶然发现碰撞瘤。基因分析显示为具有生发中心B细胞亚型和突变的DLBCL碰撞瘤,以及结肠管状绒毛状腺瘤中发生的腺癌,伴有突变和启动子甲基化。患者术后3个月死亡。据我们所知,这是第23例报道的结直肠腺癌与淋巴瘤碰撞瘤病例。23例患者的平均年龄为73岁。最常见部位是盲肠。15例有随访数据,其中11例存活,4例死亡,3年总生存率为71.5%。
基于病理和基因分析,手术联合化疗或放化疗可能对碰撞瘤有良好治疗效果。