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Scarlotta M, Avery R, Baraban E, Maleki Z, Ged Y. Case Report: New Onset Lymphadenopathy After Immune Checkpoint Inhibitor Therapy Presents a Clinicopathological and Radiological Challenge. Front Oncol 2022; 12:876797. [PMID: 35669423 PMCID: PMC9165714 DOI: 10.3389/fonc.2022.876797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
The use of immune-checkpoint inhibitor (ICI) therapy has significantly improved patient outcomes in a wide variety of cancers and has become a cornerstone in the treatment of renal cell carcinoma. However, ICI treatment has the potential to cause a variety of immune-related adverse events (irAEs) that can affect any tissue or organ. This report describes the diagnostic dilemma of a patient with both RCC and diffuse large B-cell lymphoma who developed acute onset of fever and diffuse lymphadenopathy following treatment with combined ipilimumab and nivolumab. While diagnostic considerations included worsening lymphoma, hyperprogression of RCC, sarcoid-like reaction from immunotherapy, and fungal infection, his lymphadenopathy eventually resolved with treatment for histoplasmosis and discontinuation of immunotherapy. Despite only receiving two doses of immunotherapy, he has not required additional systemic therapy for RCC. This case demonstrates both the effectiveness of ICI therapy and the need for multidisciplinary approach to potential irAEs.
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Affiliation(s)
- Matthew Scarlotta
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Robin Avery
- Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Ezra Baraban
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Zahra Maleki
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Yasser Ged
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
- *Correspondence: Yasser Ged,
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2
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Une tumeur rénale pas si conventionnelle…. Ann Pathol 2020; 40:483-486. [DOI: 10.1016/j.annpat.2020.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 01/15/2020] [Accepted: 02/25/2020] [Indexed: 11/23/2022]
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3
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Shields LBE, Kalebasty AR. Concurrent renal cell carcinoma and hematologic malignancies: Nine case reports. World J Clin Oncol 2020; 11:644-654. [PMID: 32879850 PMCID: PMC7443826 DOI: 10.5306/wjco.v11.i8.644] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 05/21/2020] [Accepted: 06/27/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The presence of renal cell carcinoma (RCC) and hematologic malignancies (HM) in the same patient is rarely observed. Three primary findings have been described in these patients, including male gender and lymphoid malignancy predominance, and the HM are usually diagnosed before or simultaneously with the RCC. There is a lack of evidence about clinical outcomes in this setting. We report the common characteristics of 9 patients diagnosed with concurrent RCC and HM and their clinical course and response to treatment.
CASE SUMMARY Four (44%) patients were diagnosed with RCC prior to the HM, the diagnosis was simultaneous in 4 (44%) patients, and 1 (11%) patient was diagnosed with the HM prior to the RCC. No patients were treated with cytotoxic chemotherapy or radiation between the diagnosis of RCC and HM. Several unique features were seen in our case series, such as 3 simultaneous cancers in 1 (11%) patient, a splenectomy leading to remission of diffuse large B cell lymphoma without the use of chemotherapy in 1 (11%) patient, chemotherapy and rituximab for lymphoma resulting in a complete response in primary RCC in 1 (11%) patient, and immunotherapy providing an excellent response for primary renal leiomyosarcoma in 1 (11%) patient.
CONCLUSION These findings highlight the potential role of immune system dysregulation in patients with the diagnosis of RCC and HM whereby the first malignancy predisposes to the second through an immunomodulatory effect. HM have the potential of being confused with lymph node metastasis from kidney cancer. Lymph node biopsy may be necessary at the time of initial diagnosis or in cases of mixed response to therapy. Long-term medical surveillance is warranted when a patient is diagnosed with RCC or HM. Clinicians should be aware of the higher prevalence of male gender and lymphoid malignancy with concurrent RCC and HM and that either of these conditions may be diagnosed first or they may be diagnosed simultaneously.
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Affiliation(s)
- Lisa BE Shields
- Norton Neuroscience Institute, Norton Healthcare, Louisville, KY 40202, United States
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Taneja A, Kumar V, Chandra AB. Primary renal lymphoma: A population-based analysis using the SEER program (1973-2015). Eur J Haematol 2020; 104:390-399. [PMID: 31769538 PMCID: PMC7216951 DOI: 10.1111/ejh.13360] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 11/05/2019] [Accepted: 11/06/2019] [Indexed: 12/17/2022]
Abstract
Objective Primary renal lymphoma (PRL) is defined as a non‐Hodgkin lymphoma (NHL) restricted to kidneys without extensive nodal disease. The literature on epidemiology and outcome in PRL is limited to case reports and small case series. Methods We utilized Surveillance, Epidemiology, and End Result database (1984‐2015) to study the demographic, clinical, and pathological characteristics of PRL. We conducted analysis to assess factors associated with overall survival (OS) and cause‐specific survival (CSS). Results A total of 599 (0.17% of all NHL) patients were eligible for the study. The age‐adjusted incidence was 0.035/100,000 population and is increasing. The median age was 72 years, and most of the patients were Caucasians and were males. Most of the patients had unilateral tumors, and diffuse large B‐cell lymphoma (DLBCL) was the most common histologic type. The median OS was 112 months, while median CSS was not reached. Age ≥ 60 years was the strongest independent risk factor for worse OS and CSS, while non‐DLBCL histology was associated with better OS and CSS. Discussion Primary renal lymphoma is a rare lymphoma with increasing incidence in more recent years. In this study, we describe demographic, clinical, and pathological characteristics of PRL and factors affecting survival among these patients.
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Affiliation(s)
- Alankrita Taneja
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, MI, USA
| | - Vivek Kumar
- Department of Internal Medicine, Medical Oncology, Brigham and Women's Hospital, Boston, MA, USA.,Dana-Farber Cancer Institute, Boston, MA, USA
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Kohn M, Karras A, Zaidan M, Bénière C, de Fréminville JB, Laribi K, Perrin MC, Malphettes M, Le Calloch R, Anglaret B, Martiniuc J, Bailly S, Chevret S, Molina T, Thervet E, Thieblemont C. Lymphomas with kidney involvement: the French multicenter retrospective LyKID study. Leuk Lymphoma 2020; 61:887-895. [PMID: 32037948 DOI: 10.1080/10428194.2019.1697811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The LyKID study is a nationwide survey in France of lymphoma patients with renal involvement based on biopsy and/or imaging, to evaluate its impact on disease outcome and renal function. A total of 87 adult cases of B or T-cell lymphomas were retrospectively analyzed. Interstitial topography was observed in most of the kidney biopsies (54/66; 80%). Kidney failure (glomerular filtration rate <60 mL/min/1.73 m2) was present in 47% of patients and was associated with non-significantly different outcome. After lymphoma treatment, 44% of patients had persistent chronic kidney failure (CKF); kidney failure at diagnosis was the only parameter associated with CKF in multivariate analysis. DLBCL (diffuse large B-cell lymphomas) represented half of the series, with noticeably CNS (central neurological system) relapse in 17% patients, while fewer than one of two patients had received CNS prophylaxis. To our knowledge, the LyKID study represents the largest published non-autopsy lymphoma series with renal involvement.
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Affiliation(s)
- Milena Kohn
- Hémato-Oncologie, APHP, Hôpital Saint-Louis, Paris, France
| | - Alexandre Karras
- Néphrologie, APHP, Hôpital Européen Georges Pompidou, Paris, France
| | | | | | | | | | | | - Marion Malphettes
- Immuno-Pathologie Clinique, APHP, Hôpital Saint-Louis, Paris, France
| | - Ronan Le Calloch
- Service des Maladies du Sang, Médecine Interne, Maladies Infectieuses, CH de Quimper Cornouailles, Quimper, France
| | | | | | - Sarah Bailly
- Hématologie, Cliniques Universitaires Saint Luc Université catholique de Louvain, Bruxelles, Belgium
| | - Sylvie Chevret
- Biostatistiques, APHP, Hôpital Saint-Louis, Paris, France
| | | | - Eric Thervet
- Néphrologie, APHP, Hôpital Européen Georges Pompidou, Paris, France
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Safi M, Sun X, Wang L, Zhang X, Song J, Ameen M. Risk interrelationship among multiple primary tumors: A case report and review of literature. Medicine (Baltimore) 2018; 97:e0289. [PMID: 29642151 PMCID: PMC5908637 DOI: 10.1097/md.0000000000010289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Along with advanced management in oncology, great progress has been recently achieved in the studies of multiple primary tumors. Several reports have studied the coexistence between lymphoma and either renal cell carcinoma (RCC) or Warthin tumor. However, the level of coexistence between these cases remains unclear due to the absence of a distinct link between them. PATIENT CONCERNS We present a unique case of multiple primary tumors (lymphoma, RCC, and Warthin tumor) in an 80-year-old man and a review of the literature on the coexistence of RCC with lymphoma and lymphoma with Warthin tumor. DIAGNOSIS With a history of RCC, the patient had a freely movable lump under his left ear, and the pathological report indicated Hodgkin lymphoma and Warthin tumor. INTERVENTION RCC and Warthin tumor of the patient were surgically treated, followed by 2 cycles (14 days per cycle) of Epirubicin 40 mg day 1, Bleomycin 8 mg day 1, Vincristine 2 mg day 1, and Dacarbazine 500 mg day 1. The chemotherapy protocol was then changed to Epirubicin 40 mg day 1, Vincristine 2 mg day 1, and Dacarbazine 500 mg day 1 for 7 cycles. OUTCOMES After the last day of chemotherapy, the patient showed a complete response. LESSONS To the best of our knowledge, this paper is the first to report a case of multiple primary tumors with a complete response. For their early detection, favorable prognosis, and correlation identification, we suggest a transitive relation between these coexisting tumors. Therefore, similar studies should be conducted.
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Affiliation(s)
- Mohammed Safi
- The Second Hospital of Dalian Medical University, Shahekou, China-Dalian
| | - Xiuhua Sun
- The Second Hospital of Dalian Medical University, Shahekou, China-Dalian
| | - Lifen Wang
- The Second Hospital of Dalian Medical University, Shahekou, China-Dalian
| | - Xinwei Zhang
- The Second Hospital of Dalian Medical University, Shahekou, China-Dalian
| | - Jicheng Song
- The Second Hospital of Dalian Medical University, Shahekou, China-Dalian
| | - Mohammed Ameen
- Sino-German Cancer Diagnosis and Treatment Center, Second Affiliated Hospital of Dalian Medical University, Dalian, China
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Oyama Y, Nishida H, Kusaba T, Kadowaki H, Arakane M, Daa T, Watanabe D, Akita Y, Sato F, Mimata H, Yokoyama S. A case of anaplastic lymphoma kinase-positive renal cell carcinoma coincident with Hodgkin lymphoma. Pathol Int 2017; 67:626-631. [DOI: 10.1111/pin.12592] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 09/01/2017] [Indexed: 12/22/2022]
Affiliation(s)
- Yuzo Oyama
- Faculty of Medicine; Department of Diagnostic Pathology; Oita University; Yufu Japan
| | - Haruto Nishida
- Faculty of Medicine; Department of Diagnostic Pathology; Oita University; Yufu Japan
| | - Takahiro Kusaba
- Faculty of Medicine; Department of Diagnostic Pathology; Oita University; Yufu Japan
| | - Hiroko Kadowaki
- Faculty of Medicine; Department of Diagnostic Pathology; Oita University; Yufu Japan
| | - Motoki Arakane
- Faculty of Medicine; Department of Diagnostic Pathology; Oita University; Yufu Japan
| | - Tsutomu Daa
- Faculty of Medicine; Department of Diagnostic Pathology; Oita University; Yufu Japan
| | - Dai Watanabe
- Faculty of Medicine; Department of Urology; Oita University; Yufu Japan
| | - Yasuyuki Akita
- Faculty of Medicine; Department of Urology; Oita University; Yufu Japan
| | - Fuminori Sato
- Faculty of Medicine; Department of Urology; Oita University; Yufu Japan
| | - Hiromitsu Mimata
- Faculty of Medicine; Department of Urology; Oita University; Yufu Japan
| | - Shigeo Yokoyama
- Faculty of Medicine; Department of Diagnostic Pathology; Oita University; Yufu Japan
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Abstract
BACKGROUND Coincidence of renal cell carcinoma (RCC) and hematologic malignancies has been reported in adults but not in children. OBSERVATION We report a case of a 16-year-old girl in whom RCC was incidentally discovered on the computed tomography scan that was performed to stage her underlying Hodgkin lymphoma. Analysis of constitutional cytogenetics for common genetic aberrations that predispose to RCC did not reveal any mutations or genetic variations. However, cytogenetics on the RCC tumor demonstrated a rare reciprocal translocation between chromosomes 6 and 11, t(6;11)(p21;q12). After undergoing partial nephrectomy with regional lymphadenectomy and treatment with multiagent chemotherapy, patient is cancer-free, now 33 months from end of therapy. CONCLUSIONS This case highlights the importance for histologic confirmation of a renal mass when concurrently discovered during the diagnostic evaluation of other malignancies.
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Occurrence of renal cell carcinoma and hematologic malignancies (predominantly lymphoid) in individuals and in families. Fam Cancer 2017; 15:677-87. [PMID: 27334456 DOI: 10.1007/s10689-016-9911-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The relationship between renal cell cancer (RCC) and hematologic malignancy (HM) in the same individual has been reported for more than 20 years, and is noted in SEER database studies. Family histories suggest a familial association as well. This study evaluates the occurrence of renal cell cancer and hematologic malignancies in individual patients and families, and the occurrence of age-of-onset anticipation among generations. Family history data from our familial patient registry, including more than 700 pedigrees of familial hematologic malignancies, and 700 patients with renal cell cancer, were reviewed. Twenty-six patients with a personal history of both RCC and HM are reported. Seventy four patients with RCC are noted to have 95 family members with HM. Consistent with past reports, there was male predominance among the patients with both diseases (71 %), and among the RCC patients' relatives with HM (57 %). Also consistent was a predominance of lymphoid malignancies in those with both diseases (92 %) and in the HMs among family members of RCC patients (79 %). The majority (95 %) of HM relatives were first or second degree relatives of the patient with RCC. Thirty of 34 parent/child pairs demonstrated age of onset anticipation in which the child developed either disease at a younger age than the parent. The co-occurrence of RCC and HM in the same patient has been shown to be significantly greater than expected. Families also appear to have an increased association. The appearance of anticipation suggests that genetic factors may be significant in this association of RCC and HM.
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Renal Masses Detected on FDG PET/CT in Patients With Lymphoma: Imaging Features Differentiating Primary Renal Cell Carcinomas From Renal Lymphomatous Involvement. AJR Am J Roentgenol 2017; 208:849-853. [PMID: 28095016 DOI: 10.2214/ajr.16.17133] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study is to analyze the 18F-FDG PET/CT features of solid renal masses detected in patients with lymphoma and to evaluate the ability of PET/CT to differentiate renal cell carcinoma (RCC) from renal lymphomatous involvement. MATERIALS AND METHODS Thirty-six patients with solid renal masses on PET/CT performed for staging or follow-up of lymphoma were evaluated retrospectively. The features recorded for each renal mass included the following standardized uptake values (SUVs) on PET/CT: the maximum SUV (SUVmax), the mean SUV (SUVmean), the ratio of the SUVmax of the tumor to that of the normal kidney cortex, the ratio of the SUVmean of the tumor to that of the normal kidney cortex, the ratio of the SUVmax of the tumor to that of the normal liver, and the ratio of the SUVmean of the tumor to that of the normal liver. Renal mass size and margins (well defined vs infiltrative) and the presence of calcifications were evaluated on CT. Renal biopsy results were used as the reference standard. Relationships between imaging parameters and histopathologic findings were assessed. RESULTS Of the 36 renal masses evaluated, 22 (61.1%) were RCCs and 14 (38.9%) were renal lymphomas. All SUV metrics were higher for renal lymphomas than for RCCs (p < 0.0001, for all). All renal lymphomas had an SUVmax higher than 5.98 g/mL (median, 10.99 g/mL), whereas all RCCs had an SUVmax lower than 5.26 g/mL (median, 2.91 g/mL). No statistically significant differences in mass size or margins were found between RCCs and renal lymphoma. CONCLUSION PET/CT features may be useful for differentiating RCCs from renal involvement in patients with lymphoma with solid renal masses.
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Zabrocka E, Sierko E, Jelski S, Wojtukiewicz MZ. Simultaneous occurrence of non-Hodgkin lymphoma, renal cell carcinoma and oncocytoma: A case report. Mol Clin Oncol 2016; 5:455-457. [PMID: 27699042 DOI: 10.3892/mco.2016.970] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 07/04/2016] [Indexed: 11/06/2022] Open
Abstract
We herein report the case of a 74 year-old woman with a diffuse large B-cell lymphoma and bilateral renal masses identified on computed tomography scans during the initial staging process. Following partial bilateral nephrectomy, histopathological examination revealed renal cell carcinoma (RCC) and oncocytoma in the left and the right kidneys, respectively. Shortly afterwards, lymphoma of the left palatine tonsil was diagnosed and the patient received chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP regimen), followed by radiotherapy. Due to metastasis of the RCC to the right breast, pancreas and the area of the left psoas major muscle, systemic treatment with pazopanib was commenced. To the best of our knowledge, this is the first reported case of simultaneous diagnosis of non-Hodgkin lymphoma (NHL), RCC and oncocytoma. The aim of this study was to review the related literature, discuss issues regarding the management of this unusual case and identify possible common etiopathological mechanisms underlying the simultaneous occurrence of NHL, RCC and oncocytoma.
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Affiliation(s)
- Ewa Zabrocka
- Department of Oncology, Medical University of Bialystok, 15-027 Bialystok, Poland
| | - Ewa Sierko
- Department of Oncology, Medical University of Bialystok, 15-027 Bialystok, Poland; Comprehensive Cancer Center in Bialystok, 15-027 Bialystok, Poland
| | - Stefan Jelski
- Comprehensive Cancer Center in Bialystok, 15-027 Bialystok, Poland
| | - Marek Z Wojtukiewicz
- Department of Oncology, Medical University of Bialystok, 15-027 Bialystok, Poland; Comprehensive Cancer Center in Bialystok, 15-027 Bialystok, Poland
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Uz B, Dolasik I, Ucer O, Dagli AF, Simsek S. Chronic lymphocytic lymphoma and concomitant renal cell carcinoma (Clear Cell Type): Review of the literature. Leuk Res Rep 2016; 6:8-10. [PMID: 27453815 PMCID: PMC4941201 DOI: 10.1016/j.lrr.2016.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 06/19/2016] [Indexed: 10/26/2022] Open
Abstract
In the present report, a 73 years-old male patient who developed clear cell type renal cell carcinoma (RCC) 5 years after the diagnosis of chronic lymphocytic lymphoma (CLL) and plausible explanations for this association were discussed by the authors. The incidence of CLL and RCC occurring in the same patient is higher than that expected in the general population. Various explicative hypotheses of this concurrence include treatment-related development of a second malignancy, immunomodulatory mechanisms, viral aetiology, cytokine (interleukin 6) release from a tumor, and common genetic mutations. Further investigations are warranted.
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Affiliation(s)
- Burak Uz
- Fırat University Faculty of Medicine, Department of Internal Medicine, Division of Adult Hematology, Elazığ, Turkey
| | - Ilhan Dolasik
- Fırat University Faculty of Medicine, Department of Internal Medicine, Division of Adult Hematology, Elazığ, Turkey
| | - Ozlem Ucer
- Fırat University Faculty of Medicine, Department of Pathology, Elazığ, Turkey
| | - Adile Ferda Dagli
- Fırat University Faculty of Medicine, Department of Pathology, Elazığ, Turkey
| | - Sercan Simsek
- Fırat University Faculty of Medicine, Department of Pathology, Elazığ, Turkey
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Johnson L, Bylund J, Strup S, Howard D, Gul Z, Khan MW, Venkatesh R. Concomitant Renal Cell Carcinoma and Hematologic Malignancy in Immunosuppressed Patients. Am J Med Sci 2016; 351:480-4. [PMID: 27140706 DOI: 10.1016/j.amjms.2016.02.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 12/15/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Treatment of a renal mass in patients with hematologic malignancy or on immunosuppression can be complex and is not well defined. Surgical excision or thermal ablation of renal mass is generally recommended in view of concern for tumor progression in immunosuppressed patients. We report our management decision experience in patients and literature review on concomitant renal and hematologic malignancy. MATERIALS AND METHODS A retrospective medical record review of patients with renal cell carcinoma (RCC) and a hematologic malignancy over 3 years at our University Hospital was performed. Data were collected including patient׳s demographics, renal tumor and hematologic malignancy characteristics (stage, pathologic subtype, time of diagnosis, treatment type and prognosis). Surgical and medical management of each malignancy was reviewed and perioperative and overall outcomes are reported. RESULTS In total, 6 patients were identified with RCC and a hematologic malignancy of which 4 were on immunosuppressive therapy. A total of 5 patients had leukemia and 1 patient had multiple myeloma. Most kidney tumors were stage I, 83%; and 80% were Fuhrman grade II. There was equal distribution of clear cell and papillary-type RCC. All but 1 patient had undergone nephron-sparing surgery. Overall, 50% of our patients died within 1 year after renal surgery for pT1a tumors from causes that are unrelated to renal cancer. CONCLUSIONS Our small cohort showed significant mortality in patients with hematologic malignancy on immunosuppression, who had their renal mass treated with surgical excision or thermal ablation. However, this mortality was not secondary to surgical procedure itself. The prognosis of the hematologic malignancy might dictate the management of RCC.
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MESH Headings
- Aged
- Carcinoma, Renal Cell/etiology
- Carcinoma, Renal Cell/immunology
- Carcinoma, Renal Cell/therapy
- Female
- Humans
- Immunocompromised Host
- Kentucky
- Kidney Neoplasms/etiology
- Kidney Neoplasms/immunology
- Kidney Neoplasms/therapy
- Leukemia, Myeloid, Acute/etiology
- Leukemia, Myeloid, Acute/immunology
- Leukemia, Myeloid, Acute/therapy
- Lymphoproliferative Disorders/etiology
- Lymphoproliferative Disorders/immunology
- Lymphoproliferative Disorders/therapy
- Male
- Middle Aged
- Neoplasms, Second Primary/etiology
- Neoplasms, Second Primary/immunology
- Neoplasms, Second Primary/therapy
- Retrospective Studies
- Treatment Outcome
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Affiliation(s)
- Lewis Johnson
- Department of Urology, University of Kentucky, Lexington, Kentucky
| | - Jason Bylund
- Department of Urology, University of Kentucky, Lexington, Kentucky
| | - Stephen Strup
- Department of Urology, University of Kentucky, Lexington, Kentucky
| | - Dianne Howard
- Division of Hematology Blood & Marrow Transplantation, University of Kentucky, Lexington, Kentucky
| | - Zartash Gul
- Division of Hematology Blood & Marrow Transplantation, University of Kentucky, Lexington, Kentucky.
| | - Muhammad Waqas Khan
- Division of Hematology Blood & Marrow Transplantation, University of Kentucky, Lexington, Kentucky
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Wang J, Pulido JS, O'Neill BP, Johnston PB. Second malignancies in patients with primary central nervous system lymphoma. Neuro Oncol 2014; 17:129-35. [PMID: 24948826 DOI: 10.1093/neuonc/nou105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Primary central nervous system lymphoma (PCNSL) is a rare extranodal lymphoma with distinctive biological behaviors. The evolving treatment of PCNSL has greatly improved the outcome for patients with this disease and has stimulated interest in second malignancies (SMs) in patients diagnosed with PCNSL. METHODS The records of 129 cases of PCNSL at Mayo Clinic, diagnosed between January 1, 1988, and November 26, 2012, were reviewed. Data on clinical characteristics, laboratory parameters, treatments, outcomes, and SMs were collected. The mean follow-up time was 44.8 months (range, 0.5-240 months; median, 28.0 months). RESULTS Altogether, 28 cases with 30 (23.26%) SMs were identified. Twenty (15.50%) patients had prior or synchronous SM. Ten (7.76%) patients developed a subsequent primary cancer after PCNSL. The most common sites of prior or synchronous SMs were prostate (4/20), skin (4/20), and gastrointestinal (3/20). The most common site of the subsequent SM was skin (4/10). Two cases were identified with both prior SM and subsequent SM. CONCLUSIONS Second malignancies in cases with PCNSL were not uncommon and occurred in nearly a quarter of our cohort. Nonmelanoma skin cancers were frequently seen. Therefore, screening for SMs should also be considered in long-term follow-up of patients with PCNSL. In addition, the high incidence of subsequent cancer, synchronous cancer, and frequently seen nonmelanoma skin cancers may all indicate an immunosuppressed state in patients with PCNSL.
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Affiliation(s)
- Jun Wang
- Department of Hematology, First People's Hospital of Changde, Changde, China (J.W.); Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota (J.S.P.); Department of Neurology, Mayo Clinic, Rochester, Minnesota (B.P.O.); Division of Hematology, Mayo Clinic, Rochester, Minnesota (P.B.J.)
| | - Jose S Pulido
- Department of Hematology, First People's Hospital of Changde, Changde, China (J.W.); Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota (J.S.P.); Department of Neurology, Mayo Clinic, Rochester, Minnesota (B.P.O.); Division of Hematology, Mayo Clinic, Rochester, Minnesota (P.B.J.)
| | - Brian Patrick O'Neill
- Department of Hematology, First People's Hospital of Changde, Changde, China (J.W.); Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota (J.S.P.); Department of Neurology, Mayo Clinic, Rochester, Minnesota (B.P.O.); Division of Hematology, Mayo Clinic, Rochester, Minnesota (P.B.J.)
| | - Patrick B Johnston
- Department of Hematology, First People's Hospital of Changde, Changde, China (J.W.); Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota (J.S.P.); Department of Neurology, Mayo Clinic, Rochester, Minnesota (B.P.O.); Division of Hematology, Mayo Clinic, Rochester, Minnesota (P.B.J.)
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Incidence and Distribution of Lymphoid Neoplasm of the Urinary Tract and Male Genital Organs in an Urban Area of Northern Italy in the Last Decade. Urologia 2014; 81 Suppl 23:S20-3. [DOI: 10.5301/ru.2014.11981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2013] [Indexed: 11/20/2022]
Abstract
Introduction Lymphoid neoplasms of the urinary tract and male genital organs are relatively rare, comprising less than 5% of all primary extranodal lymphomas; only a handful of small case series and isolated case reports have been published to describe their predominant sites and subtypes. Material and Methods We searched our institution's electronic archive of pathology reports from 2001 to 2012. We considered lymphoid neoplasms involving the kidney, bladder, testes and prostate. Patient age at diagnosis, sex, clinical history, and outcome were recorded using the relevant electronic medical records. Results We identified 25 patients with lymphoid neoplasms of the urogenital tract. 11 cases out of 40 were primary genitourinary lymphomas. Mean age at diagnosis was 61.7 years (range 13–87 years). Among bladder lymphomas cases, a male predominance was noted. As regards the types of lymphoid neoplasms, the following subtypes were observed: diffuse large B-cell lymphoma (32%), chronic lymphocytic leukemia (24%), small lymphocytic lymphoma (20%), Malt lymphoma (8%), Burkitt lymphoma (4%), follicular lymphoma (4%); diffuse large B-cell ALK+ (4%) and lymphoblastic lymphoma (4%). Conclusions Genitourinary tract lymphomas most commonly occurred in the kidney. B-cell non-Hodgkin's lymphomas were predominant, with diffuse large B-cell lymphoma being the most common subtype in the entire group. Although this study confirms the predominance of diffuse large B-cell lymphoma in extranodal sites, the findings also highlight the variety of lymphomas that may occur in the genitourinary tract. This diversity of subtypes affirms the importance of fully characterizing lymphomas by immunohistochemistry and other modalities, which are indispensable for accurate diagnosis.
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Abstract
OBJECTIVE This article reviews the CT and MRI patterns of primary and secondary renal lymphomas and discusses the role of percutaneous biopsy in diagnosis and management. CONCLUSION Renal lymphoma has a variable imaging spectrum and may mimic renal cell carcinoma. An awareness of the typical and atypical imaging features of both primary and secondary renal lymphomas can help the radiologist to suggest these diagnoses and recommend biopsy when appropriate.
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Sargın G, Yavasoglu I. Renal cell carcinoma and chronic lymphocytic leukemia. Med Oncol 2013; 30:547. [PMID: 23526444 DOI: 10.1007/s12032-013-0547-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 03/15/2013] [Indexed: 12/24/2022]
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Sargın G, Yavasoglu I, Doger FK, Kadikoylu G, Bolaman Z. A coincidence of renal cell carcinoma and hematological malignancies. Med Oncol 2012; 29:3335-8. [PMID: 22843308 DOI: 10.1007/s12032-012-0316-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 07/17/2012] [Indexed: 02/08/2023]
Abstract
Hematological malignancies with renal cell carcinoma (RCC) are rarely seen. We reported here two cases of coincidence of RCC with multiple myeloma (MM) and Hodgkin's disease (HD). A 69-year-old male patient with tumor that was located at the upper pole of left kidney was admitted to our clinic. Partial tumoral resection was performed and stage-I RCC was diagnosed after the histopathological examination of tumor. Moreover, he was diagnosed with IgG kappa stage-IIA MM as a result of bone marrow examination and serum immunofixation electrophoresis. Radiotherapy, combination chemotherapy, and autologous stem cell transplantation (ASCT) were performed. The patient is still alive who achieve a complete remission. A 53-year-old male patient suffered from cervical lymphadenopathy. He has a story of right radical nefrectomy that has been performed 4 years ago. Stage II-B lymphocyte-predominant HD was diagnosed. Combination chemotherapy was started, but relapse occurred 25 months later. ASCT was not planned due to cardiovascular problems and the patient died. Clinicians should keep in mind the coincidence of RCC with MM and HD.
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Synchronous second primary neoplasms detected by initial staging F-18 FDG PET/CT examination in patients with non-Hodgkin lymphoma. Clin Nucl Med 2011; 36:509-12. [PMID: 21637049 DOI: 10.1097/rlu.0b013e318217541d] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF THE REPORT Cases of synchronous non-Hodgkin lymphoma (NHL) and second primary carcinoma in previously untreated immunocompetent patients are relatively rare. The aim of this part of our prospective study was to a revealed 2-F-18 fluoro-2-deoxy-D-glucose (F-18 FDG) positron emission tomography (PET)-positive lesion in an extranodal organ suggestive of second primary neoplasm in newly diagnosed NHL patients. MATERIALS AND METHODS A total of 209 patients with NHL underwent initial staging F-18 FDG PET/computed tomography (CT). The finding was assessed by a radiologist, nuclear medicine physician, and hematologist. In 6 suspicious cases (2.9%) of second neoplasm, the decision was made to perform further investigations before lymphoma therapy. RESULTS Two patients were diagnosed with colorectal carcinoma, 1 with esophageal adenocarcinoma, 1 with invasive ductal breast carcinoma, 1 with medullary thyroid carcinoma, and 1 with squamous cell lung carcinoma. In 5 of the 6 patients, the second solid tumor was completely asymptomatic and revealed only by F-18 FDG PET/CT examination. CONCLUSIONS We conclude that in patients with NHL, appropriate imaging, clinical, and histologic analysis of organ lesions detected by F-18 FDG PET/CT will occasionally demonstrate significant synchronous neoplasms.
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Guo R, Chang L, Liu Z, Li AX, Huang Q, Ann DK, Wang HC, Lin CW, Wu X, Yuan YC, Yen Y. Canonical nuclear factor κB pathway links tumorigenesis of synchronous mantle-cell lymphoma, clear-cell renal-cell carcinoma, and GI stromal tumor. J Clin Oncol 2011; 29:e257-61. [PMID: 21220613 DOI: 10.1200/jco.2010.32.1802] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
MESH Headings
- Aged
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Carcinoma, Renal Cell/diagnosis
- Carcinoma, Renal Cell/genetics
- Carcinoma, Renal Cell/immunology
- Carcinoma, Renal Cell/therapy
- Chemotherapy, Adjuvant
- Comparative Genomic Hybridization
- Cyclophosphamide/administration & dosage
- Cytokines/blood
- Digestive System Surgical Procedures
- Doxorubicin/administration & dosage
- Gastrointestinal Stromal Tumors/diagnosis
- Gastrointestinal Stromal Tumors/genetics
- Gastrointestinal Stromal Tumors/immunology
- Gastrointestinal Stromal Tumors/therapy
- Gene Expression Regulation, Neoplastic
- Humans
- Immunohistochemistry
- Inflammation Mediators/blood
- Kidney Neoplasms/diagnosis
- Kidney Neoplasms/genetics
- Kidney Neoplasms/immunology
- Kidney Neoplasms/therapy
- Lymphoma, Mantle-Cell/diagnosis
- Lymphoma, Mantle-Cell/genetics
- Lymphoma, Mantle-Cell/immunology
- Lymphoma, Mantle-Cell/therapy
- Male
- NF-kappa B/genetics
- Neoplasm Staging
- Neoplasms, Multiple Primary
- Prednisone/administration & dosage
- Rituximab
- Signal Transduction/genetics
- Treatment Outcome
- Vincristine/administration & dosage
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Henriksen KJ, Meehan SM, Chang A. Nonneoplastic kidney diseases in adult tumor nephrectomy and nephroureterectomy specimens: common, harmful, yet underappreciated. Arch Pathol Lab Med 2009; 133:1012-25. [PMID: 19642728 DOI: 10.5858/133.7.1012] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2008] [Indexed: 11/06/2022]
Abstract
CONTEXT Nonneoplastic kidney diseases, such as arterionephrosclerosis and/or diabetic nephropathy, are commonly encountered in tumor nephrectomy and nephroureterectomy specimens. Although any nonneoplastic kidney disease may be encountered in these resection specimens by chance, additional diseases that may be related to the underlying neoplasm or its treatment regimen include thrombotic microangiopathy, Amyloid A amyloidosis, membranous nephropathy, immunoglobulin A nephropathy, membranoproliferative glomerulonephritis, pauci-immune crescentic glomerulonephritis, focal segmental glomerulosclerosis, minimal-change disease, acute interstitial nephritis, and xanthogranulomatous pyelonephritis. Given the morbidity of chronic kidney disease and the relatively favorable 5-year survival rates for urothelial and renal cell carcinomas, accurate evaluation of the nonneoplastic kidney parenchyma is important. OBJECTIVES We will discuss our approach for evaluating the nonneoplastic kidney parenchyma in tumor nephrectomy and nephroureterectomy specimens. The pathologic features of the aforementioned kidney diseases as well as pertinent references will be reviewed. The identification of glomerular abnormalities, including mesangial sclerosis or hypercellularity, segmental sclerosis, crescent formation, glomerulitis, or glomerular basement membrane alterations, should lead to additional immunofluorescence and electron microscopic studies. Safeguards to ensure that the nonneoplastic parenchyma is not overlooked include adding this important parameter to synoptic reports and obtaining periodic acid-Schiff and/or Jones methenamine silver stains prior to microscopic evaluation of the neoplasm. DATA SOURCES Relevant literature and University of Chicago Medical Center pathology archives. CONCLUSIONS The practicing surgical pathologist should be aware of the importance of both correctly classifying the resected renal or urothelial neoplasm and the concomitant nonneoplastic kidney disease that may be present in these specimens.
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Affiliation(s)
- Kammi J Henriksen
- Department of Pathology, University of Chicago Medical Center, Chicago, Illinois 60637, USA
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Serefhanoglu S, Buyukasik Y, Goker H, Akin SC, Akin S, Sayinalp N, Haznedaroglu IC, Ozcebe OI. Concomitant renal cell carcinoma and lymphoid malignancies: a case series of five patients and review of the literature. Med Oncol 2009; 27:55-8. [PMID: 19212710 DOI: 10.1007/s12032-009-9170-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Accepted: 01/21/2009] [Indexed: 12/19/2022]
Abstract
Appearance of non-Hodgkin's lymphomas (NHL) and renal cell carcinoma (RCC) in same person has been reported in the literature. There is a higher-than-expected incidence of co-occurrence of these neoplastic disorders. The cause for this association remains speculative. Two epidemiological studies have shown that the observed-to-expected ratio for occurrence of RCC in NHL patients were 1.86 to 2.67. We herein describe five patients with both RCC and lymphoid malignancies, and reviewed possible explanations for the association. In three of the five patients, RCC was diagnosed during lymphoproliferative disease work-up, and remaining two cases had been diagnosed with chronic lymphocytic leukemia 1 and 5 years prior to RCC. All RCC cases were detected during staging of the primary tumor, usually by CT scan and/or ultrasound. Our data are in correlation with the literature that there is an increased association of RCC and NHL more often among male patients, and that the lymphoproliferative disease often presents with extranodal involvement. The specialists should be alerted for this possibility when evaluating patients at diagnosis or during follow-up.
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Affiliation(s)
- Songul Serefhanoglu
- Division of Hematology, Department of Internal Medicine, Hacettepe University Hospital, Ankara, Turkey.
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Licci S, Brenna A, Abbate I, Ascani S. The association between non-Hodgkin lymphoma and renal cell carcinoma in an HIV-positive patient: clinico-pathological features and pathogenic implications. Am J Hematol 2008; 83:759. [PMID: 18615452 DOI: 10.1002/ajh.21238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
MESH Headings
- Carcinoma, Renal Cell/etiology
- Carcinoma, Renal Cell/virology
- Epstein-Barr Virus Infections/complications
- Fatal Outcome
- HIV Infections/complications
- Humans
- Immunocompromised Host
- Kidney Neoplasms/etiology
- Kidney Neoplasms/virology
- Lymphoma, AIDS-Related/etiology
- Lymphoma, AIDS-Related/virology
- Lymphoma, Large B-Cell, Diffuse/etiology
- Lymphoma, Large B-Cell, Diffuse/virology
- Male
- Middle Aged
- Neoplasms, Multiple Primary/etiology
- Neoplasms, Multiple Primary/virology
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Thway K, Freeman A, Woodhouse CRJ, Fisher C. Epithelial-stromal tumor of seminal vesicle in a patient with chromophobe renal cell carcinoma and small lymphocytic lymphoma. Ann Diagn Pathol 2007; 12:433-9. [PMID: 18995209 DOI: 10.1016/j.anndiagpath.2007.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Biphasic tumors of the seminal vesicle are rare. We report a further case in a 61-year-old man of a seminal vesicle epithelial-stromal tumor with focally atypical epithelial and stromal cells, the latter displaying a smooth muscle immunophenotype. In addition, this was associated with 2 synchronous malignant neoplasms, chromophobe renal cell carcinoma and small lymphocytic lymphoma, both of which were detected incidentally after clinical presentation because of the seminal vesicle mass.
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Affiliation(s)
- Khin Thway
- Royal Marsden Hospital, London SW36JJ, UK
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Sullu Y, Donmez G, Kandemir B, Gun S. Renal cell carcinoma with non-Hodgkin's lymphoma infiltration: a case report. Pathol Res Pract 2007; 203:625-7. [PMID: 17662539 DOI: 10.1016/j.prp.2007.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2007] [Revised: 05/24/2007] [Accepted: 06/08/2007] [Indexed: 10/23/2022]
Abstract
The coexistence of renal cell carcinoma and non-Hodgkin's lymphoma is more common than expected in the general population; however, renal cell carcinoma with infiltration by non-Hodgkin's lymphoma has rarely been reported. Here we report on a 77-year-old patient who presented with small lymphocytic lymphoma in the jugulodigastric lymph node. He underwent nephrectomy for a renal mass 5 months later. On histopathological examination, the mass was diagnosed as a grade III renal cell carcinoma with infiltrated small lymphocytic lymphoma that was positive for B-cells (CD20). This case is discussed in terms of the coexistence of these tumors and tumor to tumor metastasis.
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Affiliation(s)
- Yurdanur Sullu
- Faculty of Medicine, Department of Pathology, Ondokuz Mayis University, 55139 Samsun, Turkey.
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