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Lung Adenocarcinoma and Synchronous B- Cell Lymphoma of Stomach FREE TO VIEW

Elif Sen, MD; Azra Yasar, MD; Serpil Dizbay Sak, MD; Güngör Utkan, MD; Esra Erden, MD; Sevgi Saryal, MD
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Ankara University Medical School Pulmonary Diseases Department, Ankara, Turkey

Chest. 2015;148(4_MeetingAbstracts):601A. doi:10.1378/chest.2260615
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SESSION TITLE: Malignant Disease Global Case Reports

SESSION TYPE: Global Case Report Poster

PRESENTED ON: Tuesday, October 27, 2015 at 01:30 PM - 02:30 PM

INTRODUCTION: Lymphoma and solid organ tumors can occur sequentially. In this very rare condition, it is a difficult to determine the staging of each neoplasm and the optimal treatment approach.

CASE PRESENTATION: A 60-year-old man was admitted with malaise,epigastric pain,fever, dyspnea,hemoptysis and productive cough.He had a diagnosis of pneumonia and were on antibiotics at admission.A right hilar enlargement,paracardiac irregular opacities were present on his chest x-ray.Physical examination revealed bilateral rhonchi,palpable epigastric mass,dullness to percussion over Traube's space.Thoraco-abdominal tomography showed right lower lobe atelectasis, bilateral pleural effusion,right hilar, mediastinal lymphadenopathies,antral wall thickness of stomach with multiple intraabdominal lymph nodes,ascites and splenomegaly.Bronchoscopic biopsy from endobronchial lesion on the right intermediate bronchus confirmed the diagnosis of lung adenocarcinoma. Stomach biopsy of the antral mass lesion reported a synchronous B-cell Non-Hodgkin lymphoma(NHL). Positron emission tomography images detected uptake in the multiple mediastinal, right hilar, left supraclavicular lymph nodes, right lower lobe,in the stomach and multiple comglomerated intraabdominal lymph nodes.Left supraclavicular lymph node needle aspiration revealed a metastasis from lung adenocarcinoma and even the staging of lung cancer and lymphoma could not be determined strictly, this finding was concordant with an inoperable lung cancer. The therapy for lung adenocarcinoma and lymphoma was administered with a five day regimen of rituximab-vincristin, prednisolone in medical oncology ward.

DISCUSSION: The result of diagnostic studies showed a rare co-existence of lung cancer and lymphoma originated from stomach. Staging cannot be completed thoroughly by imaging studies after histopathologic diagnosis of each malignancy in synchronous malignancies.

CONCLUSIONS: Inoperable lung adenocancer and NHL case was presented to discuss the diagnostic, staging end treatment challenges at this rare co-occurence.

Reference #1: Fujii M, Shirai T, Asada K et al.Synchronous diffuse large B-cell lymphoma and squamous cell lung carcinoma. <span style="line-height:1.6">Respirol Case Rep. 2014 Mar;2(1):33-5.</span>

Reference #2: Papajík T, Mysliveček M, Sedová Z et al. Synchronous second primary neoplasms detected by initial staging F-18 FDG PET/CT examination in patients with non-Hodgkin lymphoma. <span style="line-height:1.6">Clin Nucl Med. 2011 Jul;36(7):509-12.</span>

DISCLOSURE: The following authors have nothing to disclose: Elif Sen, Azra Yasar, Serpil Dizbay Sak, Güngör Utkan, Esra Erden, Sevgi Saryal

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