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Guimaraes N, Bolais Monica I, Oliveira S, Pato Pais D, Andrade S, Bertao Colaco I, Vila Nova C, Vieira V, Azenha N, Fonseca Pinho J, Guedes F, Conceicao L, Valente Cecilio J. Lymphoepithelioma-Like Gastric Carcinoma and Gastric Involvement of Chronic Lymphocytic Leukemia: Two Rare Identities Coexisting in One Patient. J Med Cases 2022; 13:36-39. [PMID: 35211234 PMCID: PMC8827247 DOI: 10.14740/jmc3846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/06/2022] [Indexed: 11/23/2022] Open
Abstract
Lymphoepithelioma-like gastric carcinoma (LELGC) constitutes 1-4% of all gastric carcinomas and gastrointestinal involvement in leukemia can be present in up to 25%, being more common in acute than chronic leukemia, affecting most frequently the stomach, ileum, and proximal colon. LELGC is usually associated with a better prognosis than other gastric carcinomas, generally presenting with low T and N stages. The reports of chronic lymphocytic leukemia (CLL) involving infiltration of the gastrointestinal tract are relatively rare in the literature, and the estimated incidence ranges from 5.7% to 25%. We present the case of a 77-year-old female, on surveillance by a known CLL that was diagnosed with gastric carcinoma on an esophagogastroduodenoscopy (EGD) performed for epigastric pain. A subtotal gastrectomy was performed and the surgical specimen revealed simultaneous involvement of the stomach by LELGC and CLL. To the best of our knowledge, this is the first reported case of a LELGC and CLL simultaneously involving the stomach.
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Affiliation(s)
- Narcisa Guimaraes
- Department of Surgery, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal,Corresponding Author: Narcisa Guimaraes, Department of Surgery, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal.
| | - Ines Bolais Monica
- Department of Surgery, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal
| | - Simone Oliveira
- Department of Surgery, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal
| | - Daniela Pato Pais
- Department of Surgery, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal
| | - Sara Andrade
- Department of Surgery, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal
| | - Ines Bertao Colaco
- Department of Surgery, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal
| | - Carlos Vila Nova
- Department of Surgery, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal
| | - Vera Vieira
- Department of Surgery, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal
| | - Nuno Azenha
- Department of Surgery, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal
| | - Joao Fonseca Pinho
- Department of Surgery, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal
| | - Fatima Guedes
- Department of Internal Medicine, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal
| | - Lucilia Conceicao
- Department of Surgery, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal
| | - Jose Valente Cecilio
- Department of Surgery, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal
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Cheng AW, Abdeljaber M, Lima NA, Shebrain S. Large Bowel Obstruction in the Setting of Small Lymphocytic Lymphoma. Cureus 2020; 12:e9640. [PMID: 32923240 PMCID: PMC7480891 DOI: 10.7759/cureus.9640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 08/09/2020] [Indexed: 11/05/2022] Open
Abstract
Large bowel obstruction (LBO) is a potential surgical emergency, commonly caused by colorectal carcinoma, diverticular stricture, and volvulus. LBO secondary to chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) is a rare occurrence. We report an 81-year-old man with a history of CLL/SLL who presented to the emergency department with episodes of abdominal cramps and discomfort, diarrhea, vomiting, subjective flushes, and sweats. After a thorough evaluation, the patient was found to have a malignancy-mediated mechanical LBO at the hepatic flexure due to colonic compression by extensive pericolic lymphadenopathy. After resuscitation and medical optimization, an urgent laparotomy with oncologic right hemicolectomy was performed. Analysis of resected specimens, including lymph nodes, revealed atypical CD23- CLL/SLL cells. Postoperatively, aside from temporary ileus, the patient recovered well and was discharged home.
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Affiliation(s)
- Abigail W Cheng
- Surgery, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USA
| | - Mahmuod Abdeljaber
- Surgery, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USA
| | - Neiberg A Lima
- Internal Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USA
| | - Saad Shebrain
- Surgery, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USA
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