BACKGROUND Mucosa-associated lymphoid tissue (MALT) lymphoma is a subtype of non-Hodgkin lymphoma that is mainly involved in the gastrointestinal tract. Thesynchronous occurrence of colonic MALT lymphoma and adenocarc...BACKGROUND Mucosa-associated lymphoid tissue (MALT) lymphoma is a subtype of non-Hodgkin lymphoma that is mainly involved in the gastrointestinal tract. Thesynchronous occurrence of colonic MALT lymphoma and adenocarcinoma in thesame patient is extremely rare. We here report a case of synchronous colonicMALT lymphoma found on surveillance colonoscopy five months after surgeryand chemotherapy for sigmoid adenocarcinoma.CASE SUMMARY A 67-year-old man was admitted because of hematochezia for two months.Colonoscopy suggested a colonic tumor before hospitalization. Abdominalcomputed tomography (CT) revealed local thickening of the sigmoid colon. Thepatient underwent a left hemicolectomy with local lymph node dissection. Thehistopathology revealed moderately differentiated adenocarcinoma and partiallymucinous adenocarcinoma. The pTNM stage was T3N1Mx. The patient receivedchemotherapy with six cycles of mFOLFOX6 after surgery. Colonoscopy wasperformed five months later and revealed single, flat, polypoid lesions of thecolon 33 cm away from the anus. Subsequently, the patient underwent endoscopic mucosal resection for further diagnosis. The pathological diagnosis was MALTlymphoma. Positron emission tomography /CT suggested metastasis. The patientrefused further treatment and died ten months later.CONCLUSION Colonic MALT lymphoma may occur after surgery and chemotherapy foradenocarcinoma as a synchronous malignancy. Regular surveillance colonoscopyand careful monitoring after surgery are critical.展开更多
BACKGROUND Chronic lymphocytic leukemia/small lymphocytic lymphoma(CLL/SLL) is often associated with an increased risk of developing subsequent neoplasms of epithelial and mesenchymal origin.Coincidence of CLL/SLL and...BACKGROUND Chronic lymphocytic leukemia/small lymphocytic lymphoma(CLL/SLL) is often associated with an increased risk of developing subsequent neoplasms of epithelial and mesenchymal origin.Coincidence of CLL/SLL and urothelial carcinoma(UC) is very rare.Herein,we report a case of synchronous renal pelvis carcinoma with SLL.CASE SUMMARY A 78-year-old man presented with the complaint of terminal painless gross hematuria for the past 2 mo.On physical examination,enlarged lymph nodes were palpable in the cervical and axillary regions.The patient’s peripheral blood film was normal.He had a significant smoking history for the past 50 years.Cystoscopy revealed bleeding in the left upper urinary tract.Abdominal computed tomography imaging demonstrated a left renal pelvis tumor.The patient underwent laparoscopic radical nephroureterectomy.Histopathology revealed left renal pelvis high-grade invasive papillary UC and SLL involving the kidney and bone marrow.Renal pelvis lymphatic tissue and lymphocytes were positive for CD5,CD20,and CD23.In addition,the following results were obtained:CD3(-),Ki-67(30%+),Bcl-2(+),Bcl-6(+),CD10(-),and CD79a(+).Moreover,no UC metastasis was observed in the lymph nodes.CONCLUSION This is the first case of coincident CLL/SLL and upper tract UC in the literature.Cancer patients with lymphadenopathies should always be investigated to rule out the possibility of synchronous or metachronous malignancy.展开更多
BACKGROUND Synchronous combined hepatocellular-cholangiocarcinoma(CHC)and hepatocellular carcinoma(HCC)is very rare,with few literature reports and poor clinical outcomes associated with the disorder.Surgical resectio...BACKGROUND Synchronous combined hepatocellular-cholangiocarcinoma(CHC)and hepatocellular carcinoma(HCC)is very rare,with few literature reports and poor clinical outcomes associated with the disorder.Surgical resection is the main treatment,which makes the preoperative diagnosis very important.However,due to imaging manifestations overlapping with HCC,diagnosis of this type of synchronous cancer is challenging and it tends to be misdiagnosed as multiple HCC.Herein,we report the contrast-enhanced ultrasound(CEUS)manifestations of a case of synchronous CHC and HCC,aiming at adding to the understanding of this disease.CEUS displayed exquisite vascularity and tissue perfusion in real time with good spatial and temporal resolution and more accurately reflect tumor washin and washout times than contrast-enhanced computed tomography(CT)in this case.CASE SUMMARY The patient was a 69-year-old female with a 20-year history of chronic hepatitis B.Due to months of epigastric pain and anorexia,she reffered to our hospital for treatment.Five days before hospitalization,abdominal magnetic resonance imaging performed at another hospital detected a space-occupying lesion in the liver.After her hospitalization,laboratory tests showed elevated alpha-fetoprotein and carbohydrate antigen 19-9 level.Two suspicious liver lesions located in S4 and S6,respectively,were identified in a cirrhotic background by abdominal contrast-enhanced CT(CECT).Furthermore,the lesion in S4 and S6 were detected by CEUS and assigned to CEUS LI-RADS 5 and M categories,respectively.The patient underwent tumor radical resections.Post-operative pathology confirmed the S4 and S6 lesions to be HCC and CHC,respectively.A newly-found suspicious liver nodule with potential malignancy was detected in liver S1 by both CEUS and CECT 7 mo after operation.CONCLUSION The CEUS characteristics of CHC and HCC are different.CEUS features in combination with clinical information could help in effective diagnosis,clinical decision-making and better prognosis.展开更多
文摘BACKGROUND Mucosa-associated lymphoid tissue (MALT) lymphoma is a subtype of non-Hodgkin lymphoma that is mainly involved in the gastrointestinal tract. Thesynchronous occurrence of colonic MALT lymphoma and adenocarcinoma in thesame patient is extremely rare. We here report a case of synchronous colonicMALT lymphoma found on surveillance colonoscopy five months after surgeryand chemotherapy for sigmoid adenocarcinoma.CASE SUMMARY A 67-year-old man was admitted because of hematochezia for two months.Colonoscopy suggested a colonic tumor before hospitalization. Abdominalcomputed tomography (CT) revealed local thickening of the sigmoid colon. Thepatient underwent a left hemicolectomy with local lymph node dissection. Thehistopathology revealed moderately differentiated adenocarcinoma and partiallymucinous adenocarcinoma. The pTNM stage was T3N1Mx. The patient receivedchemotherapy with six cycles of mFOLFOX6 after surgery. Colonoscopy wasperformed five months later and revealed single, flat, polypoid lesions of thecolon 33 cm away from the anus. Subsequently, the patient underwent endoscopic mucosal resection for further diagnosis. The pathological diagnosis was MALTlymphoma. Positron emission tomography /CT suggested metastasis. The patientrefused further treatment and died ten months later.CONCLUSION Colonic MALT lymphoma may occur after surgery and chemotherapy foradenocarcinoma as a synchronous malignancy. Regular surveillance colonoscopyand careful monitoring after surgery are critical.
文摘BACKGROUND Chronic lymphocytic leukemia/small lymphocytic lymphoma(CLL/SLL) is often associated with an increased risk of developing subsequent neoplasms of epithelial and mesenchymal origin.Coincidence of CLL/SLL and urothelial carcinoma(UC) is very rare.Herein,we report a case of synchronous renal pelvis carcinoma with SLL.CASE SUMMARY A 78-year-old man presented with the complaint of terminal painless gross hematuria for the past 2 mo.On physical examination,enlarged lymph nodes were palpable in the cervical and axillary regions.The patient’s peripheral blood film was normal.He had a significant smoking history for the past 50 years.Cystoscopy revealed bleeding in the left upper urinary tract.Abdominal computed tomography imaging demonstrated a left renal pelvis tumor.The patient underwent laparoscopic radical nephroureterectomy.Histopathology revealed left renal pelvis high-grade invasive papillary UC and SLL involving the kidney and bone marrow.Renal pelvis lymphatic tissue and lymphocytes were positive for CD5,CD20,and CD23.In addition,the following results were obtained:CD3(-),Ki-67(30%+),Bcl-2(+),Bcl-6(+),CD10(-),and CD79a(+).Moreover,no UC metastasis was observed in the lymph nodes.CONCLUSION This is the first case of coincident CLL/SLL and upper tract UC in the literature.Cancer patients with lymphadenopathies should always be investigated to rule out the possibility of synchronous or metachronous malignancy.
文摘BACKGROUND Synchronous combined hepatocellular-cholangiocarcinoma(CHC)and hepatocellular carcinoma(HCC)is very rare,with few literature reports and poor clinical outcomes associated with the disorder.Surgical resection is the main treatment,which makes the preoperative diagnosis very important.However,due to imaging manifestations overlapping with HCC,diagnosis of this type of synchronous cancer is challenging and it tends to be misdiagnosed as multiple HCC.Herein,we report the contrast-enhanced ultrasound(CEUS)manifestations of a case of synchronous CHC and HCC,aiming at adding to the understanding of this disease.CEUS displayed exquisite vascularity and tissue perfusion in real time with good spatial and temporal resolution and more accurately reflect tumor washin and washout times than contrast-enhanced computed tomography(CT)in this case.CASE SUMMARY The patient was a 69-year-old female with a 20-year history of chronic hepatitis B.Due to months of epigastric pain and anorexia,she reffered to our hospital for treatment.Five days before hospitalization,abdominal magnetic resonance imaging performed at another hospital detected a space-occupying lesion in the liver.After her hospitalization,laboratory tests showed elevated alpha-fetoprotein and carbohydrate antigen 19-9 level.Two suspicious liver lesions located in S4 and S6,respectively,were identified in a cirrhotic background by abdominal contrast-enhanced CT(CECT).Furthermore,the lesion in S4 and S6 were detected by CEUS and assigned to CEUS LI-RADS 5 and M categories,respectively.The patient underwent tumor radical resections.Post-operative pathology confirmed the S4 and S6 lesions to be HCC and CHC,respectively.A newly-found suspicious liver nodule with potential malignancy was detected in liver S1 by both CEUS and CECT 7 mo after operation.CONCLUSION The CEUS characteristics of CHC and HCC are different.CEUS features in combination with clinical information could help in effective diagnosis,clinical decision-making and better prognosis.
