Incidental lymphoma in lymph node dissection for carcinoma in the abdominopelvic cavity: a single-institution experience

Successful treatment of a case with synchronous follicular lymphoma and gastric adenocarcinoma with CD19 CAR T cells and literature review

WHAT IS KNOWN AND OBJECTIVE

Anti-CD19 CAR-T cell therapy is effective in B-cell lymphoma. However, it is rarely used in lymphoma combined with other malignant tumours.

CASE DESCRIPTION

A relapsed/refractory follicular lymphoma (r/r FL) patient underwent anti-CD19 CAR-T cell therapy and achieved complete response to lymphoma. However, gastric adenocarcinoma (GAC) was diagnosed during the cellular therapy. After infusion of CAR-T cells, he received curative treatment for GAC, and maitained complete response in both r/r FL and GAC after the treatment.

WHAT IS NEW AND CONCLUSION

Anti-CD19 CAR-T therapy is an effective treatment for r/r FL, also provided opportunity for the sequential therapy of GAC, and remained significant quality of life afterwards.

Incidental lymphomas in surgical pathology: diagnostic clues and clinical-pathological correlations

Incidental lymphomas (ILs) are rare and challenging lesions with poorly characterized clinical-epidemiological and histological features. The present study addressed the open issues concerning these tumors, by assessing the clinical-pathological features of 28 consecutive ILs, diagnosed over a 10-year period at a tertiary center for surgical pathology. ILs were more frequently documented in elderly males (mean age at surgery 70.8 years; M/F ratio 3.3), with sharp prevalence of gastrointestinal and urinary tract involvement (22/28 [78.6%] cases). Low-grade B-cell lymphomas outnumbered all other entities, and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) was the most common subtype (18/28 [64.3%] cases). Compared to other ILs, CLL/SLL occurred at older age and was the sole lymphoid neoplasm affecting the urinary tract. In conclusion, ILs are rare lesions, mostly affecting the gastrointestinal and urinary tract of elderly males. The diagnosis of IL is based on a high degree of suspicion and on careful morphological/phenotypic characterization.